Provider Demographics
NPI:1578881900
Name:WATSON, THOMAS HINES (RN)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:HINES
Last Name:WATSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 RED CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-4408
Mailing Address - Country:US
Mailing Address - Phone:716-681-5806
Mailing Address - Fax:
Practice Address - Street 1:26 RED CLOVER LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NY
Practice Address - Zip Code:14086-4408
Practice Address - Country:US
Practice Address - Phone:716-681-5806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256238163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult