Provider Demographics
NPI:1003202193
Name:WATSON, ANN MARIE (FNP, DNP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:WATSON
Suffix:
Gender:F
Credentials:FNP, DNP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP,DNP
Mailing Address - Street 1:92 N 4TH ST.
Mailing Address - Street 2:SUITE 18
Mailing Address - City:MARTINS FERRY
Mailing Address - State:OH
Mailing Address - Zip Code:43935
Mailing Address - Country:US
Mailing Address - Phone:740-633-4305
Mailing Address - Fax:740-633-4178
Practice Address - Street 1:302 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8801
Practice Address - Country:US
Practice Address - Phone:740-232-6210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN54221-FNP-BC363LF0000X
OHCOA.17216-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH440050Medicare PIN