Provider Demographics
NPI:1467468587
Name:WATSON, JILL ARNOLD (NP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:ARNOLD
Last Name:WATSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 SAN FELIPE DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-0351
Mailing Address - Country:US
Mailing Address - Phone:214-662-9893
Mailing Address - Fax:
Practice Address - Street 1:2300 MARIE CURIE DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5706
Practice Address - Country:US
Practice Address - Phone:972-272-6561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX630478363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX630478OtherNURSE PRACTITIONERS