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General NPI Number Information
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NPI Number | 1396178992
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Entity Type | Individual
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Provider Name | LINDA LUCKY WATSON X RN
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Gender | Female
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Dates
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Enumeration Date | 08/19/2013
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Last Update Date | 08/19/2013
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Provider Practice Location Address
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Address Line | 11545 N FRANK LLOYD WRIGHT BLVD APT 2050
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-3141
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Country | US
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Telephone | 904-945-5009
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Fax |
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Provider Business Mailing Address
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Address Line | 11545 N FRANK LLOYD WRIGHT BOULAVARD APT 2050
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-2717
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Country | US
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Telephone | 904-945-5009
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 246661-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN111928
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN111928
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN111928
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License Number State | AZ
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