Provider Demographics
NPI:1982143897
Name:WATSON, COURTNEY (CNM)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:WHEAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6609 VIRGINIA PKWY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5513
Mailing Address - Country:US
Mailing Address - Phone:972-542-8884
Mailing Address - Fax:
Practice Address - Street 1:6609 VIRGINIA PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5513
Practice Address - Country:US
Practice Address - Phone:972-542-8884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133287367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife