| NPI | 1245974336 |
|---|---|
| Former Name | PENNY ANN WATSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016044) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: NC 2014-00018) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2023-06-23 |