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Individual

MS. LINDA LUCKY WATSON X

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
11545 N FRANK LLOYD WRIGHT BLVD, APT 2050, SCOTTSDALE, AZ 85259-3141
(904) 945-5009
Mailing address
11545 N FRANK LLOYD WRIGHT BOULAVARD, APT 2050, SCOTTSDALE, AZ 85259-2717
(904) 945-5009

Taxonomy

Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
246661-1
NY
163WC1500X
Community Health Registered Nurse
Primary
RN111928
AZ
163WG0000X
General Practice Registered Nurse
RN111928
AZ
163WH0200X
Home Health Registered Nurse
RN111928
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
246661-1
REGISTERED NIRSE LICENSE
NY
01
AZRN111928
ARIZONA REGISTERED NURSE LICENSE NUMBER AZ RN 111928
AZ
Enumeration date
08/19/2013
Last updated
08/19/2013
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