| NPI | 1669800397 |
|---|---|
| Former Name | CARLA MODISETT WATSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP07394) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07394) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2021-06-29 |