Provider Demographics
NPI:1750684296
Name:WATSON, TAMRAH JOY (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:TAMRAH
Middle Name:JOY
Last Name:WATSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 ALDEN LN
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-3522
Mailing Address - Country:US
Mailing Address - Phone:919-219-8479
Mailing Address - Fax:
Practice Address - Street 1:20 DUKE MEDICINE CIRCLE DUKE HEALTH
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-4300
Practice Address - Country:US
Practice Address - Phone:919-668-5213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC203688363LF0000X
NC5005016363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004721Medicaid
NC2595148Medicare PIN
NC7004721Medicaid