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General NPI Number Information
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NPI Number | 1376290999
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Entity Type | Individual
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Provider Name | JESSICA L WATTS NP-C
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Gender | Female
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Dates
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Enumeration Date | 03/03/2022
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 11700 N MERIDIAN ST
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City | CARMEL
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State | IN
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Zip | 46032-4656
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Country | US
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Telephone | 317-688-3068
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Fax |
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Provider Business Mailing Address
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Address Line | 13579 SILVERSTONE DR
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City | FISHERS
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State | IN
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Zip | 46037-7991
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Country | US
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Telephone | 574-529-0203
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71012335A
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License Number State | IN
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