Individual
KIMBERLY GROHT WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
6550 MAIN ST STE 1000, ZACHARY, LA 70791-4092
(225) 654-1559
(225) 654-6212
Mailing address
6550 MAIN ST STE 1000, ZACHARY, LA 70791-4092
(225) 654-1559
(225) 654-6212
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
222087
LA
Other
Enumeration date
11/09/2021
Last updated
05/24/2022
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