Individual
LORI ANN WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3002 STATE HWY K, OFALLON, MO 63368
(866) 389-2727
Mailing address
3002 STATE HWY K, OFALLON, MO 63368
(866) 389-2727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2018013353
MO
363LF0000X
Family Nurse Practitioner
209008310
IL
Other
Enumeration date
08/23/2010
Last updated
07/19/2018
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