Provider Demographics
NPI:1194454280
Name:WATTS, SHARON TALAYLA (N/A)
Entity Type:Individual
Prefix:MISS
First Name:SHARON
Middle Name:TALAYLA
Last Name:WATTS
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:MISS
Other - First Name:SHARON
Other - Middle Name:TALAYLA
Other - Last Name:WATTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:2631 HOUSLEY RD # 1069
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7030
Mailing Address - Country:US
Mailing Address - Phone:443-979-2636
Mailing Address - Fax:
Practice Address - Street 1:1349 SHIRLEYVILLE RD
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2541
Practice Address - Country:US
Practice Address - Phone:410-757-3218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty