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General NPI Number Information
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NPI Number | 1003181611
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Entity Type | Individual
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Provider Name | MRS. ASHLEY BETH WATTERSON
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Gender | Female
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Dates
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Enumeration Date | 03/14/2012
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Last Update Date | 04/07/2021
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Provider Practice Location Address
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Address Line | 115 S CHURCH ST
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City | BERRYVILLE
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State | VA
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Zip | 22611-1369
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Country | US
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Telephone | 540-955-4811
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Fax | 540-955-0976
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Provider Business Mailing Address
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Address Line | 136 LINDEN DR SUITE 104
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City | WINCHESTER
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State | VA
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Zip | 22601-6900
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Country | US
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Telephone | 540-678-3588
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Fax | 540-678-9025
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 203742
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0024171488
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License Number State | VA
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