MEDICARE: RACHEL DAWN WATSON ARNP

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	773793	TX

General Provider Information

NPI Number	:	1720040223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL DAWN WATSON ARNP

Provider Business Mailing Address
First Line	:	3418 NW 135TH ST STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-4009
Country	:	US
Telephone Number	:	405-753-6142
Fax Number	:	405-730-8089

Provider Business Practice Location Address
First Line	:	3418 NW 135TH ST STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-4009
Country	:	US
Telephone Number	:	405-753-6142
Fax Number	:	405-730-8089

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

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	05/17/2021

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