Edna R Watts, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN036579NP Issued in GA

Practice address

1012 Ga Highway 247 S
Kathleen, GA 31047-2349

Phone

(478) 987-1261

Fax

(478) 218-0839

NPI assigned

Jul 8, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1922006444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "KATHLEEN",
            "state": "GA",
            "postal_code": "310470189",
            "telephone_number": "478-987-1261",
            "fax_number": "478-218-0839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 GA HIGHWAY 247 S",
            "city": "KATHLEEN",
            "state": "GA",
            "postal_code": "310472349",
            "telephone_number": "478-987-1261",
            "fax_number": "478-218-0839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "EDNA",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN036579NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000812798A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Travis Lee Clinic
• Shivani Vasudev-Patel, DMD
• Sierra Logan Vaughan, LAMFT
• Jeffrey Wade
• Sarai Watlington
• Shawn David Wilding Sr., MS, NBCC
• Lisa M Williams
• Megan J Wilshire, PHARMD
• Regina Catherine Wuest, PT
• Casey Marie Yerby, LMSW

• Family Nurse Practitioner in Kathleen, GA
• Providers in Kathleen, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.