Provider Demographics
NPI:1407274798
Name:WATSON, KATELYN P (PA-C)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:P
Last Name:WATSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:PARENTEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:246 PLEASANT ST.
Mailing Address - Street 2:MEMORIAL BUILDING, WEST, FLOOR 1
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2548
Mailing Address - Country:US
Mailing Address - Phone:603-224-3388
Mailing Address - Fax:603-227-7536
Practice Address - Street 1:246 PLEASANT ST.
Practice Address - Street 2:MEMORIAL BUILDING, WEST, FLOOR 1
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-224-3388
Practice Address - Fax:603-227-7536
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1024363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant