Basic Information
| Provider Information | |||||||||
| NPI: | 1942562525 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WATSON | ||||||||
| FirstName: | KATRINA | ||||||||
| MiddleName: | H. | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 827 LINDEN AVE | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212014606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548382588 | ||||||||
| FaxNumber: | 9545143979 | ||||||||
| Practice Location | |||||||||
| Address1: | 1613 HARRISON PKWY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SUNRISE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333232896 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548382588 | ||||||||
| FaxNumber: | 9545143979 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2012 | ||||||||
| LastUpdateDate: | 10/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN9291009 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.