Healthcare Provider Details

I. General information

NPI: 1326441916
Provider Name (Legal Business Name): CYNTHIA DAWN WATSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2014
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 IRONTON HILLS DR # B-1
IRONTON OH
45638-9700
US

IV. Provider business mailing address

1735 27TH ST STE B06
PORTSMOUTH OH
45662-2681
US

V. Phone/Fax

Practice location:
  • Phone: 740-442-7300
  • Fax: 740-442-7550
Mailing address:
  • Phone: 740-356-7942
  • Fax: 740-353-7900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.16619
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: