MEDICARE: BEVERLY WATSON CRNA

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	163WC0200X	Critical Care Medicine Registered Nurse	042789	NC

General Provider Information

NPI Number	:	1437366853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY WATSON CRNA

Provider Business Mailing Address
First Line	:	PO BOX 16444
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-6444
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3931 TINSLEY DR STE 104
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-1533
Country	:	US
Telephone Number	:	336-841-5400
Fax Number	:

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	07/08/2007

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Directions to “ BEVERLY WATSON CRNA” Practice Location

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