MEDICARE: CONNER WATTS

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1447183421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNER WATTS

Provider Business Mailing Address
First Line	:	60 BLACKBERRY LN
Second Line	:
City	:	WAYNE
State	:	WV
Zip	:	25570-6543
Country	:	US
Telephone Number	:	304-429-0070
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 BLACKBERRY LN
Second Line	:
City	:	WAYNE
State	:	WV
Zip	:	25570-6543
Country	:	US
Telephone Number	:	304-429-0070
Fax Number	:

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

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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Directions to “ CONNER WATTS ” Practice Location

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