Provider Demographics
NPI:1952884744
Name:WATTS, CATHERINE MWANIKI
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MWANIKI
Last Name:WATTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12078 FAIRQUARTER LN
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:TX
Mailing Address - Zip Code:77362-1525
Mailing Address - Country:US
Mailing Address - Phone:832-231-8907
Mailing Address - Fax:
Practice Address - Street 1:12078 FAIRQUARTER LN
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:TX
Practice Address - Zip Code:77362-1525
Practice Address - Country:US
Practice Address - Phone:832-231-8907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-08
Last Update Date:2018-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212533164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse