Healthcare Provider Details

I. General information

NPI: 1821230657
Provider Name (Legal Business Name): CONSTANCE B WATTS RXN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2009
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 E 9TH AVE SUITE 300
DENVER CO
80220-3901
US

IV. Provider business mailing address

658 ULSTER WAY
DENVER CO
80230-7179
US

V. Phone/Fax

Practice location:
  • Phone: 303-322-5595
  • Fax:
Mailing address:
  • Phone: 303-341-1444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN46907
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: