Provider Demographics
NPI:1285315929
Name:SINGLETON WATTERS, TIANDRA VERSHAWN (APRN-WHNP)
Entity type:Individual
Prefix:
First Name:TIANDRA
Middle Name:VERSHAWN
Last Name:SINGLETON WATTERS
Suffix:
Gender:F
Credentials:APRN-WHNP
Other - Prefix:
Other - First Name:TIANDRA
Other - Middle Name:VERSHAWN
Other - Last Name:SINGLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4241 SKIPJACK CV
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-7150
Mailing Address - Country:US
Mailing Address - Phone:931-249-7654
Mailing Address - Fax:
Practice Address - Street 1:2820 NAPOLEON AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6969
Practice Address - Country:US
Practice Address - Phone:504-842-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA229720207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology