Individual
MRS. NANCY JANE WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
12000 STONE LAKE, DULCE, NM 87528
(505) 759-3291
(505) 759-7249
Mailing address
474 GREAT WEST AVENUE, POB 2009, PAGOSA SPRINGS, CO 81147
(970) 264-0990
(505) 759-7294
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
R36235
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000K3526
—
NM
01
—
HSZ196
MEDICARE PART B
NM
Enumeration date
07/28/2006
Last updated
05/27/2008
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