Individual
FANAE WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1418 MCCOY DR, HARRISON, AR 72601-2411
(870) 754-3347
Mailing address
1418 MCCOY DR, HARRISON, AR 72601-2411
(870) 754-3547
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
2019003239
MO
363LF0000X
Family Nurse Practitioner
A004640
AR
Other
Enumeration date
02/05/2016
Last updated
10/03/2023
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