Individual
KATHRYN DEACON WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
600 RIDGELY AVE STE 130, ANNAPOLIS, MD 21401-1045
(410) 266-8049
(410) 266-0787
Mailing address
600 RIDGELY AVE STE 130, ANNAPOLIS, MD 21401-1045
(410) 266-8049
(410) 266-0787
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R176362
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
510532300
—
MD
01
—
96829001
BCBS
MD
01
—
96829002
BCBS
MD
01
—
96829003
BCBS
MD
01
—
96829004
BCBS
MD
01
—
D3800010
BCBS
DC
01
—
J4570011
BCBS
DC
01
—
W8490007
BCBS
DC
Enumeration date
07/19/2010
Last updated
08/05/2024
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