Provider Demographics
NPI:1093327470
Name:WATSON, EDIE (DNP, WHNP)
Entity Type:Individual
Prefix:DR
First Name:EDIE
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:DNP, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15095 N THOMPSON PEAK PKWY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2874
Mailing Address - Country:US
Mailing Address - Phone:602-403-8722
Mailing Address - Fax:
Practice Address - Street 1:15095 N THOMPSON PEAK PKWY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2874
Practice Address - Country:US
Practice Address - Phone:602-403-8722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ242922363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health