Healthcare Provider Details

I. General information

NPI: 1447063649
Provider Name (Legal Business Name): ARIEL S WATSON NP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 16TH AVE N STE G
MYRTLE BEACH SC
29577-3537
US

IV. Provider business mailing address

3825 MARKET ST STE 6
WILMINGTON NC
28403-1426
US

V. Phone/Fax

Practice location:
  • Phone: 843-501-1099
  • Fax:
Mailing address:
  • Phone: 910-777-5575
  • Fax: 910-777-5273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number31239
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: