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General NPI Number Information
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NPI Number | 1770685927
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Entity Type | Individual
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Provider Name | ROSE MARIE WATTS ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 6100 SAINT JOHNS AVE STE 6
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City | PALATKA
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State | FL
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Zip | 32177
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Country | US
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Telephone | 386-325-5699
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Fax | 386-325-5644
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Provider Business Mailing Address
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Address Line | 6100 SAINT JOHNS AVE STE 6
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City | PALATKA
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State | FL
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Zip | 32177-6859
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Country | US
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Telephone | 386-325-5699
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Fax | 386-325-5644
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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 | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 2514352
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License Number State | FL
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