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General NPI Number Information
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NPI Number | 1023103090
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Entity Type | Individual
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Provider Name | JULIE FAE WATTS APRN
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/08/2013
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Provider Practice Location Address
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Address Line | 500 N 5TH ST
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City | HOT SPRINGS
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State | SD
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Zip | 57747-1480
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Country | US
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Telephone | 800-764-5370
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Fax | 605-745-2890
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Provider Business Mailing Address
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Address Line | 899 E 6TH ST
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City | CHADRON
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State | NE
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Zip | 69337-2711
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Country | US
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Telephone | 308-432-2513
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Fax | 605-745-2890
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 110329
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License Number State | NE
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