Individual
WILMA J WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1051186
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000652462B
—
GA
05
—
051515685
—
AL
05
—
08808065
—
MS
05
—
1772488
—
LA
05
—
301241700
—
FL
01
—
5151685
BLUE CROSS BLUE SHIELD
AL
01
—
P00096410
RR MEDICARE
—
Enumeration date
03/31/2006
Last updated
10/30/2018
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