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General NPI Number Information
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NPI Number | 1760736706
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Entity Type | Individual
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Provider Name | MONIQUE WATTS FNP
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Gender | Female
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Dates
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Enumeration Date | 10/29/2012
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 15900 SNOW RD STE 600
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City | BROOKPARK
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State | OH
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Zip | 44142-2861
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Country | US
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Telephone | 440-467-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 13203 MAPLEROW AVE
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City | GARFIELD HEIGHTS
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State | OH
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Zip | 44105-6925
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Country | US
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Telephone | 443-801-2854
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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 | 0040238
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 379529
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License Number State | OH
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