Provider Demographics
NPI:1659637312
Name:WATSON, JAMES EDWIN JR (DNP-BC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWIN
Last Name:WATSON
Suffix:JR
Gender:M
Credentials:DNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 4TH ST NW
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:FL
Mailing Address - Zip Code:32052-6603
Mailing Address - Country:US
Mailing Address - Phone:386-792-0700
Mailing Address - Fax:386-406-8370
Practice Address - Street 1:506 4TH ST NW
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:FL
Practice Address - Zip Code:32052-6603
Practice Address - Country:US
Practice Address - Phone:386-792-0700
Practice Address - Fax:386-406-8370
Is Sole Proprietor?:No
Enumeration Date:2012-04-07
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN201031363LA2200X
FL9459097363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health