Provider Demographics
NPI:1396700688
Name:WATSON, SHERRY KAY (CRNA)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:KAY
Last Name:WATSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 FRANKLIN ST SE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4551
Mailing Address - Country:US
Mailing Address - Phone:256-539-9471
Mailing Address - Fax:256-539-9472
Practice Address - Street 1:460 LANIER RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-1866
Practice Address - Country:US
Practice Address - Phone:256-319-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-089791367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051524899Medicaid
AL51524899OtherBCBS
AL51524899OtherBCBS
AL051524899Medicare ID - Type UnspecifiedMEDICARE