MRS. FAWN RENEE WATTS


Address: 18181 Oakwood Blvd, Suite 208, Dearborn, MI 48124-5032
Phone: 3132715565

MRS. FAWN RENEE WATTS (NPI# 1134502040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134502040
Entity Type Individual
Full Name MRS. FAWN RENEE WATTS
Credential AGACNP-BC
Practice Address 18181 Oakwood Blvd
Suite 208
Dearborn
MI 48124-5032
Mailing Address 35421 Wood St
Livonia
MI 48154-2273
Practice Telephone 3132715565
Mailing Telephone 7345240665
Enumeration Date 2015-07-09
Last Update Date 2015-07-24
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 4704234529 MI Nursing Service Providers
Y 363LA2100X Nurse Practitioner
Specialization: Acute Care
4704234529 MI Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 18181 OAKWOOD BLVD
SUITE 208
City DEARBORN
State MI
Zip Code 48124-5032

Providers in the same location

NPI Name Taxonomy Address Enumeration
1013994425 Maria F Hayes Obstetrics & Gynecology 18181 Oakwood Blvd, Ste 109, Dearborn, MI 48124 2005-12-28
1619402203 Ola Abol Hosn Nurse Practitioner 18181 Oakwood Blvd, Dearborn, MI 48124-5032 2017-04-20
1578014502 Vijayalakshmi Nagappan Md PC Internal Medicine 18181 Oakwood Blvd, Suite 101, Dearborn, MI 48124-5032 2016-10-14
1386192417 William Beaumont Hospital Durable Medical Equipment & Medical Supplies 18181 Oakwood Blvd, #104, Dearborn, MI 48124-5032 2016-09-19
1730530973 Ccma Beaumont Pllc Internal Medicine 18181 Oakwood Blvd, Suite 208, Dearborn, MI 48124-5032 2016-06-29
1023465010 Katherine Anne Repp Nurse Practitioner 18181 Oakwood Blvd, Suite 101, Dearborn, MI 48124-5032 2016-05-19
1851768717 Miada Saad Physician Assistant 18181 Oakwood Blvd, Dearborn, MI 48124-5032 2015-08-27
1174909592 Ian Lytle Md PC Plastic Surgery 18181 Oakwood Blvd, Suite 200, Dearborn, MI 48124-5032 2015-08-07
1467834598 Maryam Mohammad-pour Daryaee Audiologist 18181 Oakwood Blvd, Suite 402, Dearborn, MI 48124-5032 2015-06-25
1700279783 Brandon Robert Helchowski Nurse Practitioner 18181 Oakwood Blvd, Suite 403, Dearborn, MI 48124-5032 2015-03-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1396389524 Pharma A, LLC Pharmacy 23916 Michigan Ave, Dearborn, MI 48124 2019-10-31
1225683725 Aysha Said Behavior Technician 1369 Porter St, Dearborn, MI 48124 2019-08-02
1881257772 Leen Nusairat Internal Medicine Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 2019-04-17
1417413360 Gary C. Veraghen, Dds, PC Dentist 22100 W. Outer Drive, Dearborn, MI 48124 2019-02-15
1982168787 Fnu Asma Manzar Physical Therapist Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 2019-01-25
1639640162 Jernia Lashawn Usher Behavior Technician 1360 Porter St Lower Level, Dearborn, MI 48124 2018-12-10
1710456470 Samar Fouad Hannawi Psychologist 3815 Pelham Street, Suite #13, Dearborn, MI 48124 2018-11-24
1881178747 Sarah Chehab Psychologist 835 Mason St Suite 220b, Dearborn, MI 48124 2018-09-17
1568948289 Ibrahim M Basma Pharmacist 22521 Michigan Avenue, Dearborn, MI 48124 2018-07-16
1669961942 Jacqueline E Domzalski Technician, Other 3231 S. Gulley, Suite E, Dearborn, MI 48124 2018-05-02
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Taxonomy Information

Taxonomy Code 363LA2100X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Acute Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437759396 Zainab Ali Hachem Nurse Practitioner 5158 Neckel St, Dearborn, MI 48126-3217 2020-10-29
1578044962 Jaclyn Mae Phillion Nurse Practitioner 23550 Park St Ste 100, Dearborn, MI 48124-2592 2018-08-24
1770006637 Ashley Marie Wozniak Nurse Practitioner 1537 Monroe St Ste 100, Dearborn, MI 48124-2842 2017-07-24
1659752913 Rebecca Steele Nurse Practitioner 22651 Garrison St, Dearborn, MI 48124-2125 2015-06-12
1003184268 Robin Wawersik Nurse Practitioner 18181 Oakwood Blvd Ste 207, Dearborn, MI 48124-5031 2011-12-02
1821311481 Jacqueline Ann Parker Nurse Practitioner 4538 Rosalie St, Dearborn, MI 48126-2827 2010-03-10
1346863271 Allison Mae Harris Nurse Practitioner 18101 Oakwood Blvd, Dearborn, MI 48124-4089 2020-05-27
1417597279 Lena Mathena Nurse Practitioner 22720 Michigan Ave Ste 200, Dearborn, MI 48124-2021 2020-01-09
1639714280 Kelly Ann Hopkins Nurse Practitioner 18101 Oakwood Blvd, Dearborn, MI 48124-4089 2019-11-07
1417410739 Lauren Collavino Nurse Practitioner 18101 Oakwood Blvd, Dearborn, MI 48124-4089 2019-04-12
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Competitor

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City DEARBORN
Zip Code 48124

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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