Individual
JORDYN L WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
Mailing address
1400 E CACTUS AVE, POST FALLS, ID 83854-6066
(208) 365-8161
(877) 389-5153
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60283274
WA
363LA2100X
Acute Care Nurse Practitioner
68454
ID
363LA2100X
Acute Care Nurse Practitioner
Primary
AP61063402
WA
Other
Enumeration date
04/06/2020
Last updated
10/10/2025
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