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General NPI Number Information
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NPI Number | 1225183163
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Entity Type | Individual
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Provider Name | PAMELA P WATSON NP C
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4365 JOHNS CREEK PARKWAY SUITE 400
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City | SUWANEE
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State | GA
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Zip | 30024
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Country | US
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Telephone | 678-957-1910
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Fax | 678-957-1911
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Provider Business Mailing Address
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Address Line | 4365 JOHNS CREEK PARKWAY SUITE 400
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City | SUWANEE
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State | GA
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Zip | 30024
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Country | US
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Telephone | 678-957-1910
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Fax | 678-957-1911
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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 | RN142904
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License Number State | GA
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