CANDY WATTS (NPI# 1841525961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841525961 |
| Entity Type | Individual |
| Full Name | CANDY WATTS |
| Credential | APRN, CNS, C-NP |
| Practice Address |
1145 S Utica Ave Ste 1105 Tulsa OK 74104-4000 |
| Mailing Address |
Po Box 2369 Borrego Springs CA 92004-2369 |
| Practice Telephone | 9185795749 |
| Practice Fax Number | 9185605791 |
| Mailing Telephone | (760) 767-5051 |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
60794 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 364SA2100X |
Clinical Nurse Specialist Specialization: Acute Care |
0060794 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4343 Yaqui Pass Road, Borrego Springs, CA 92004 | 9188993089 |
| Street Address |
1145 S UTICA AVE STE 1105 |
| City | TULSA |
| State | OK |
| Zip Code | 74104-4000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336133024 | Michael Opong-kusi | Family Medicine | 1145 S Utica Ave, Suite 460, Tulsa, OK 74104-4000 | 2005-09-08 |
| 1639631690 | Gautami Gandham | Student in an Organized Health Care Education/Training Program | 1145 S Utica Ave, Tulsa, OK 74104-4000 | 2019-04-01 |
| 1265948269 | Linda Ellard | Nurse Practitioner | 1145 S Utica Ave, Ste 460, Tulsa, OK 74104-4041 | 2017-12-28 |
| 1972038602 | Laquichesha Trotter | Nurse Practitioner | 1145 S Utica Ave, Suite 364, Tulsa, OK 74104-4000 | 2017-05-01 |
| 1265966980 | Jubin Sadeghian | Student in an Organized Health Care Education/Training Program | 1145 S Utica Ave, Tulsa, OK 74104-4000 | 2017-04-19 |
| 1881128775 | Jacqueline R Froese | Nurse Practitioner | 1145 S Utica Ave, Ste 110, Tulsa, OK 74104-4000 | 2017-04-18 |
| 1861931891 | Brittany Goodin | Nurse Practitioner | 1145 S Utica Ave, Ste 460, Tulsa, OK 74104-4000 | 2017-02-23 |
| 1447796545 | Haresh K Ajmera Md Inc | Specialist | 1145 S Utica Ave, Suite 500, Tulsa, OK 74104-4014 | 2017-01-12 |
| 1396281937 | Chih-ying Lee | Physician Assistant | 1145 S Utica Ave, Suite 460, Tulsa, OK 74104-4000 | 2017-01-06 |
| 1023562204 | Katie Rodgers | Nurse Practitioner | 1145 S Utica Ave, Ste 460, Tulsa, OK 74104-4000 | 2016-08-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 364SA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023415841 | Suzanne Kirby | Clinical Nurse Specialist | 1145 S Utica Ave Ste 1105, Tulsa, OK 74104 | 2014-11-21 |
| 1538777552 | Kallie Danielle Garrett | Clinical Nurse Specialist | 10505 E 91st St, Tulsa, OK 74133-5801 | 2020-07-15 |
| 1427409358 | Kimberly Byler | Clinical Nurse Specialist | 1120 S Utica Ave, Tulsa, OK 74104-4012 | 2016-06-22 |
| 1710354832 | Christine Marie Vincent | Clinical Nurse Specialist | 6161 S Yale Ave, Tulsa, OK 74136-1902 | 2015-08-24 |
| 1851773444 | Sara Elizabeth White | Clinical Nurse Specialist | 12697 E 51st St, Tulsa, OK 74146-6236 | 2015-06-19 |
| 1861817736 | Vicki R Leist | Clinical Nurse Specialist | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2014-02-28 |
| 1164847653 | Georgianne Tokarchik | Clinical Nurse Specialist | 1265 S Utica Ave, Suite 300, Tulsa, OK 74104-4243 | 2014-02-20 |
| 1700137064 | Alberto Joven Trinidad | Clinical Nurse Specialist | 1265 S Utica Ave, Suite 105, Tulsa, OK 74104-4243 | 2012-09-27 |
| 1720388846 | Julie Ann Spears | Clinical Nurse Specialist | 1810 E 15th St, Tulsa, OK 74104-4611 | 2010-10-22 |
| 1003146598 | Teressa Headrick Lemaster | Clinical Nurse Specialist | 1705 E 19th St, Suite 302, Tulsa, OK 74104-5405 | 2010-01-05 |
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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.