Provider Demographics
NPI:1639406432
Name:WATTS, MEGHAN M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:M
Last Name:WATTS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MEGHAN
Other - Middle Name:MANGRELLI
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34052 GREENFIELD CT
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-7317
Mailing Address - Country:US
Mailing Address - Phone:302-740-8678
Mailing Address - Fax:
Practice Address - Street 1:4755 OGLETOWN STANTON RD
Practice Address - Street 2:CHRISTIANA HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-733-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000688363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical