MEDICARE: ASHLEY WATSON NP-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
1	363L00000X	Nurse Practitioner	0024175174	VA
2	207Q00000X	Family Medicine Physician	F03170337	VA

General Provider Information

NPI Number	:	1407385172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY WATSON NP-C

Provider Business Mailing Address
First Line	:	513 BOSWELL CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-5857
Country	:	US
Telephone Number	:	757-577-2863
Fax Number	:

Provider Business Practice Location Address
First Line	:	513 BOSWELL CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-5857
Country	:	US
Telephone Number	:	757-577-2863
Fax Number	:	757-577-2863

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

Provider Enumeration Date	:	06/07/2017
Last Update Date	:	12/09/2024

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