Provider Demographics
NPI:1982982609
Name:WATSON, MICHELLE NOEL (CNS)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:NOEL
Last Name:WATSON
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6606 DAVID ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-2002
Mailing Address - Country:US
Mailing Address - Phone:940-691-0985
Mailing Address - Fax:940-687-4647
Practice Address - Street 1:4909 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-2547
Practice Address - Country:US
Practice Address - Phone:940-691-0985
Practice Address - Fax:940-687-4616
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253132364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health