Provider Demographics
NPI:1699578476
Name:WATTS, LEONARD EMMETT
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:EMMETT
Last Name:WATTS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 SEARLES AVE APT 1126
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-9811
Mailing Address - Country:US
Mailing Address - Phone:217-986-1132
Mailing Address - Fax:
Practice Address - Street 1:2651 SEARLES AVE APT 1126
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-9811
Practice Address - Country:US
Practice Address - Phone:217-986-1132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider