Provider Demographics
NPI:1235160854
Name:WATSON, KRISTINE JOYCE (CFNP)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:JOYCE
Last Name:WATSON
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 DORSEYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1113
Mailing Address - Country:US
Mailing Address - Phone:412-963-7350
Mailing Address - Fax:412-963-7419
Practice Address - Street 1:715 DORSEYVILLE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-1113
Practice Address - Country:US
Practice Address - Phone:412-963-7350
Practice Address - Fax:412-963-7419
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV48825363LF0000X
PASP009301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2279109Medicaid
WV7104064000Medicaid
WV7104064000Medicaid
OH2279109Medicaid