MEDICARE: CYNTHIA WATTERS BSN, RN

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	163WA2000X	Administrator Registered Nurse	RN040324	AZ

General Provider Information

NPI Number	:	1760346779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA WATTERS BSN, RN

Provider Business Mailing Address
First Line	:	4729 E SUNRISE DR STE 458
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-4534
Country	:	US
Telephone Number	:	520-323-5910
Fax Number	:	520-220-5595

Provider Business Practice Location Address
First Line	:	4729 E SUNRISE DR STE 458
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-4534
Country	:	US
Telephone Number	:	520-323-5910
Fax Number	:	520-220-5595

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

Provider Enumeration Date	:	12/13/2025
Last Update Date	:	12/13/2025

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