Provider Demographics
NPI:1508155730
Name:WATTS, PEI-YU KATHERINE (CRNA)
Entity Type:Individual
Prefix:
First Name:PEI-YU
Middle Name:KATHERINE
Last Name:WATTS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:PEIYU
Other - Middle Name:KATHERINE
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4678 YORKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-6504
Mailing Address - Country:US
Mailing Address - Phone:267-303-0425
Mailing Address - Fax:
Practice Address - Street 1:4678 YORKSHIRE DR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-6504
Practice Address - Country:US
Practice Address - Phone:267-303-0425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN179735367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered