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NPI Code Detail

MEDICARE: NICOLE WATTS NEWCOME OT

MEDICARE: NICOLE WATTS NEWCOME OT
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
1225XP0200XPediatric Occupational Therapist1880AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25A072OTHERARBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1801924394
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE WATTS NEWCOME OT
Provider Business Mailing Address
First Line : 3920 WOODLAND HEIGHTS RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72212
Country : US
Telephone Number : 501-227-3600
Fax Number :
Provider Business Practice Location Address
First Line : 3920 WOODLAND HEIGHTS RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72212-2495
Country : US
Telephone Number : 501-227-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 01/06/2011

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Directions to “ NICOLE WATTS NEWCOME OT” Practice Location

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