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NPI Code Detail

MEDICARE: CASEY MARIE WATSON FNP, PMHNP

MEDICARE:   CASEY MARIE WATSON  FNP, PMHNP
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
1363LF0000XFamily Nurse Practitioner5008351NC
2363LP0808XPsychiatric/Mental Health Nurse Practitioner5008351NC

General Provider Information

NPI Number : 1164890281
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY MARIE WATSON FNP, PMHNP
Provider Business Mailing Address
First Line : 8022 PROVIDENCE RD STE 500-229
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-9719
Country : US
Telephone Number : 704-459-2181
Fax Number : 704-533-9516
Provider Business Practice Location Address
First Line : 11220 ELM LN STE 203
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-0450
Country : US
Telephone Number : 704-459-2181
Fax Number : 704-533-9516
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2015
Last Update Date : 03/16/2026

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Directions to “ CASEY MARIE WATSON FNP, PMHNP” Practice Location

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