Individual
TAMMY G WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
3710 LANDMARK DR, STE 114, COLUMBIA, SC 29204-4034
(803) 788-5916
(803) 788-9564
Mailing address
3710 LANDMARK DR, STE 114, COLUMBIA, SC 29204-4034
(803) 851-5966
(803) 828-4618
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
455
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0642
—
SC
Enumeration date
06/07/2006
Last updated
09/18/2018
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