MEDICARE: MARGARET ELLEN WATSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN057926 NP	GA

General Provider Information

NPI Number	:	1093774424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET ELLEN WATSON

Provider Business Mailing Address
First Line	:	333 WASHINGTON AVE N
Second Line	:	STE 5000
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55401-1377
Country	:	US
Telephone Number	:	612-659-7111
Fax Number	:

Provider Business Practice Location Address
First Line	:	1498 JESSE JEWELL PKWY SE
Second Line	:	STE A
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3874
Country	:	US
Telephone Number	:	678-596-1705
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	11/10/2009

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