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).
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 |
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 |
Street Address |
18181 OAKWOOD BLVD SUITE 208 |
City | DEARBORN |
State | MI |
Zip Code | 48124-5032 |
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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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 |
Find all providers in zip 48124 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
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 |
Find all providers in DEARBORN |
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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.