Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | 1-088446 | AL |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 1-088446 | AL |
NPI | 1033542998 |
---|---|
Provider Name | Mrs. Beverly Darlene Watts |
First Address | Birmingham, AL 35211-1303 |
Second Address | Birmingham, AL 35211-1303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2013 |
Last Update Date | 14/08/2013 |