Provider Demographics
NPI:1154303626
Name:WATT, KAREN S (CNM)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:S
Last Name:WATT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:874 ED HALL DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-1861
Mailing Address - Country:US
Mailing Address - Phone:972-932-5411
Mailing Address - Fax:972-932-5425
Practice Address - Street 1:874 ED HALL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1861
Practice Address - Country:US
Practice Address - Phone:972-932-5411
Practice Address - Fax:972-932-5425
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX741092367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1973406-02Medicaid
MS00126113Medicaid
AL569100057Medicaid
730-14358OtherBLUE CROSS OF AL
TX1973406-01Medicaid
TX1973406-01Medicaid
TX1973406-01Medicaid
AL569100057Medicaid