Provider Demographics
NPI:1831419472
Name:WATSON, ANEESAH (LPN,WCC)
Entity type:Individual
Prefix:
First Name:ANEESAH
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:LPN,WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3087 REGAL LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-3136
Mailing Address - Country:US
Mailing Address - Phone:513-942-9337
Mailing Address - Fax:
Practice Address - Street 1:3087 REGAL LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-3136
Practice Address - Country:US
Practice Address - Phone:513-257-9337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-06
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN136591-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse