Individual
JESSICA WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 MCCRARY AVE, ROBERTA, GA 31078-4916
(478) 836-2819
Mailing address
PO BOX 1010, ROBERTA, GA 31078-1010
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN175509
GA
Other
Enumeration date
08/08/2017
Last updated
08/08/2017
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