Provider Demographics
NPI:1043668528
Name:WATSON, LINDA HELEN (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:HELEN
Last Name:WATSON
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 E MAIN ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-8780
Mailing Address - Country:US
Mailing Address - Phone:608-782-9675
Mailing Address - Fax:608-782-1123
Practice Address - Street 1:1828 E MAIN ST
Practice Address - Street 2:SUITE 10
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-8780
Practice Address - Country:US
Practice Address - Phone:608-782-9675
Practice Address - Fax:608-782-1123
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1230-33363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100054861Medicaid