Individual
SUZANNE WATTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
502 FARRELL DR, COVINGTON, KY 41011-3717
(859) 578-3200
Mailing address
502 FARRELL DR, COVINGTON, KY 41011-3717
(859) 578-3200
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1100648
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184607
MEDICARE GROUP NUMBER
KY
Enumeration date
07/03/2006
Last updated
07/08/2007
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