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General NPI Number Information
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NPI Number | 1881405959
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Entity Type | Individual
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Provider Name | CAMILLA EDWINA WATSON CNA HCT
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Gender | Female
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 04/13/2025
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Provider Practice Location Address
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Address Line | 1808 RUSH WIND DR
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City | CHARLOTTE
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State | NC
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Zip | 28206-2307
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Country | US
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Telephone | 704-649-6449
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 BEACON RIDGE RD APT 315
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City | CHARLOTTE
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State | NC
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Zip | 28210-3565
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Country | US
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Telephone | 980-451-6449
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 169816
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 163946
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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