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General NPI Number Information
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NPI Number | 1508495821
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Entity Type | Individual
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Provider Name | JAWANA LYNN WATSON
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Gender | Female
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 885 UNION BLVD
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City | ENGLEWOOD
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State | OH
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Zip | 45322-2102
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Country | US
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Telephone | 937-832-4091
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932958
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City | CLEVELAND
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State | OH
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Zip | 44193-0028
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Country | US
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Telephone | 615-425-4200
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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 | 026501
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License Number State | OH
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