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General NPI Number Information
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NPI Number | 1215481221
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Entity Type | Individual
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Provider Name | CHRISTY WATTS MSN,RN,FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/08/2016
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Last Update Date | 05/16/2019
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Provider Practice Location Address
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Address Line | 210 COLLEGE ST
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City | MCDONOUGH
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State | GA
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Zip | 30253-3300
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Country | US
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Telephone | 470-878-6401
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Fax |
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Provider Business Mailing Address
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Address Line | 1757 ROCK QUARRY RD STE A
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7303
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Country | US
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Telephone | 770-474-7151
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Fax | 770-474-7151
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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 | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | RN170782
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN170782
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License Number State | GA
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