Individual
EDNA R WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1012 GA HIGHWAY 247 S, KATHLEEN, GA 31047-2349
(478) 987-1261
(478) 218-0839
Mailing address
PO BOX 189, KATHLEEN, GA 31047-0189
(478) 987-1261
(478) 218-0839
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN036579NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000812798A
—
GA
Enumeration date
07/08/2005
Last updated
07/13/2011
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