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General NPI Number Information
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NPI Number | 1174547269
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Entity Type | Individual
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Provider Name | KRISTI WATTS APRN
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 210 BLACK GOLD BLVD SUITE 106
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City | HAZARD
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State | KY
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Zip | 41701-2620
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Country | US
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Telephone | 606-436-0711
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Fax | 606-436-0848
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Provider Business Mailing Address
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Address Line | 197 ANTLER DR
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City | HAZARD
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State | KY
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Zip | 41701-8223
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Country | US
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Telephone | 606-233-4575
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3004377
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License Number State | KY
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