Individual
CRYSTAL MICHELLE WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
1 RICHLAND MEDICAL PARK DR STE 420, COLUMBIA, SC 29203-6833
(803) 545-5350
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 293-7033
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
20072
SC
Other
Enumeration date
06/06/2016
Last updated
12/11/2020
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