MEDICARE: MS. KAREN S. WATT CNM

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
1	367A00000X	Advanced Practice Midwife	741092	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	730-14358	OTHER	BLUE CROSS OF AL
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154303626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN S. WATT CNM

Provider Business Mailing Address
First Line	:	874 ED HALL DR
Second Line	:	SUITE 102
City	:	KAUFMAN
State	:	TX
Zip	:	75142-1861
Country	:	US
Telephone Number	:	972-932-5411
Fax Number	:	972-932-5425

Provider Business Practice Location Address
First Line	:	874 ED HALL DR
Second Line	:	SUITE 102
City	:	KAUFMAN
State	:	TX
Zip	:	75142-1861
Country	:	US
Telephone Number	:	972-932-5411
Fax Number	:	972-932-5425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	03/07/2023

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