Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 0024171488 | VA |
N | 363LA2200X | Nurse Practitioner - Adult Health | 203742 | SC |
NPI | 1003181611 |
---|---|
Provider Name | Mrs. Ashley Beth Watterson |
First Address | Winchester, VA 22601-6900 |
Second Address | Berryville, VA 22611-1369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2012 |
Last Update Date | 07/04/2021 |