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NPI Code Detail

MEDICARE: LOGAN WATTS FNP-C

MEDICARE: LOGAN WATTS FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner5023720NC

General Provider Information

NPI Number : 1144186131
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOGAN WATTS FNP-C
Provider Business Mailing Address
First Line : 501 S SHARON AMITY RD STE 300
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-0035
Country : US
Telephone Number : 704-377-2424
Fax Number :
Provider Business Practice Location Address
First Line : 501 S SHARON AMITY RD STE 300
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-0035
Country : US
Telephone Number : 704-377-2424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2026
Last Update Date : 01/02/2026

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Directions to “ LOGAN WATTS FNP-C” Practice Location

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