Individual
BROOKE WATTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
4309 3RD AVE, SAN DIEGO, CA 92103-1407
(619) 876-4502
Mailing address
2081 BOULDERS RD, ALPINE, CA 91901-3880
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95164590
CA
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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