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General NPI Number Information
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NPI Number | 1841525961
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Entity Type | Individual
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Provider Name | CANDY WATTS APRN, CNS, C-NP
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Gender | Female
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Dates
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Enumeration Date | 10/07/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1145 S UTICA AVE STE 1105
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City | TULSA
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State | OK
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Zip | 74104-4000
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Country | US
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Telephone | 918-579-5749
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Fax | 918-560-5791
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Provider Business Mailing Address
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Address Line | PO BOX 2369
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City | BORREGO SPRINGS
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State | CA
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Zip | 92004-2369
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Country | US
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Telephone | 760-767-5051
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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 | 60794
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 364SA2100X
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Taxonomy Name | Acute Care Clinical Nurse Specialist
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License Number | 0060794
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License Number State | OK
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