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General NPI Number Information
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NPI Number | 1346755469
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Entity Type | Individual
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Provider Name | AMANDA WATT FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/12/2017
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 500 SPILLERS WAY
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City | WARNER ROBINS
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State | GA
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Zip | 31088-0513
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Country | US
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Telephone | 478-953-4844
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Fax |
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Provider Business Mailing Address
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Address Line | 2620 ELM HILL PIKE
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City | NASHVILLE
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State | TN
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Zip | 37214-3108
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Country | US
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Telephone | 877-852-2677
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | RN209660
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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 | RN209660
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License Number State | GA
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