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Individual

RUTHIE J WATTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
111 VIRGINIA AVE, PETERSBURG, WV 26847-1713
(304) 257-1666
(304) 257-9145
Mailing address
HC 59 BOX 1100, CABINS, WV 26855-9515
(304) 257-1366

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
49442
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0030591000
WV
05
0030591001
WV
Enumeration date
05/22/2007
Last updated
07/09/2007
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