MEDICARE: SETHWATSONAPRN LLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1467305896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SETHWATSONAPRN LLC

Provider Business Mailing Address
First Line	:	245 N LAKE CUNNINGHAM AVE
Second Line	:
City	:	SAINT JOHNS
State	:	FL
Zip	:	32259-7941
Country	:	US
Telephone Number	:	904-385-0586
Fax Number	:	904-734-7410

Provider Business Practice Location Address
First Line	:	12443 SAN JOSE BLVD STE 604
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-8652
Country	:	US
Telephone Number	:	904-385-0586
Fax Number	:	904-734-7410

Authorized Official
Title or Position	:	OWNER
Name	:	SETH WATSON
Credential	:
Telephone Number	:	904-385-0586

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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Directions to “SETHWATSONAPRN LLC ” Practice Location

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