Individual
MRS. KELLY CONWAY WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
12317 SOARING FLIGHT DR, JACKSONVILLE, FL 32225-0784
(904) 881-8677
Mailing address
12317 SOARING FLIGHT DR, JACKSONVILLE, FL 32225-0784
(904) 881-8677
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9348566
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003169318A
—
GA
05
—
015846600
—
FL
Enumeration date
09/22/2015
Last updated
11/23/2015
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