Healthcare Provider Details

I. General information

NPI: 1861408148
Provider Name (Legal Business Name): EMILY R WATCHMAN RN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WEST HOSPITAL DR
WHITERIVER AZ
85941
US

IV. Provider business mailing address

P.O. BOX 860
WHITERIVER AZ
85941
US

V. Phone/Fax

Practice location:
  • Phone: 928-338-3666
  • Fax:
Mailing address:
  • Phone: 928-338-3666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberR23680
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number2021-0482
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: