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Individual

SELINA LEONE WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2485 HEMBY LN, SUITE A, GREENVILLE, NC 27834-3701
(252) 752-2140
(888) 787-2249
Mailing address
2485 HEMBY LN, SUITE A, GREENVILLE, NC 27834-3701
(252) 752-2140
(888) 787-2249

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
189815
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
106620
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1225424245
TRICARE
NC
05
1225424245
NC
01
P01527753
RAILROAD MEDICARE
NC
Enumeration date
04/07/2015
Last updated
11/19/2015
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