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1285385005
SHANE MARK WATTS
LOUISVILLE, KY
NPI
1285385005
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: KY 3017240)
Enumeration Date
2022-01-13
Last Update Date
2022-01-13
Business Address
SHANE MARK WATTS APRN, PMHNP-BC
801 BARRET AVE STE 110
LOUISVILLE, KY 40204-1732
Phone number: 502-792-0275
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Mailing Address
SHANE MARK WATTS APRN, PMHNP-BC
130 LAKELYNN AVE
SHELBYVILLE, KY 40065-7403
Phone number: 502-689-9994
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