Doctor Name: | MRS. MARGO RENEE WATSON |
NPI Number: | 1013308311 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPNP |
License Number: | RN183351 |
Business Practice Address: | 426 Sw Commerce Dr Suite 101 Lake City, FL - 320251505 |
Business Phone Number: | 3867552240 |
Business Fax Number: | 3867556598 |
Mailing Address: | 207 Gleneagle Dr, BYRON |
State: | GA |
Postal Code: | 310083810 |
Phone Number: | 4785080836 |
Fax Number: | |
NPI Enumeration Date: | 02/09/2015 |
NPI Last Update Date: | 08/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | RN183351 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |