Provider Demographics
NPI:1104254572
Name:WATTS, ROBERTA MICHELLE (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:MICHELLE
Last Name:WATTS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 GEORGESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-2420
Mailing Address - Country:US
Mailing Address - Phone:614-272-7700
Mailing Address - Fax:
Practice Address - Street 1:421 GEORGESVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-2420
Practice Address - Country:US
Practice Address - Phone:614-272-7700
Practice Address - Fax:855-618-2145
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.15297363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily