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General NPI Number Information
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NPI Number | 1023632254
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Entity Type | Individual
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Provider Name | MICHELE LEIGH WATTS
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Gender | Female
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 08/07/2026
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Provider Practice Location Address
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Address Line | 1600 PROVIDENCE DR
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City | WACO
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State | TX
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Zip | 76707-2261
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Country | US
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Telephone | 254-413-4200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4144
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City | WACO
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State | TX
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Zip | 76708-0415
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Country | US
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Telephone | 682-429-8330
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Fax |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 1223563
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 684480
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License Number State | TX
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