Provider Demographics
NPI:1205495199
Name:WATSON-ORMOND, ELIZABETH ROSE (CRNM)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ROSE
Last Name:WATSON-ORMOND
Suffix:
Gender:F
Credentials:CRNM
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:ROSE
Other - Last Name:ORMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1520 MOORES CHAPEL CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-9199
Mailing Address - Country:US
Mailing Address - Phone:252-714-2592
Mailing Address - Fax:336-948-1452
Practice Address - Street 1:1520 MOORES CHAPEL CEMETERY RD
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-9199
Practice Address - Country:US
Practice Address - Phone:252-714-2592
Practice Address - Fax:336-948-1452
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCNM18367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid