Watson, Kelly Conway

Watson, Kelly Conway is an sole proprietor health care provider with primary practice located at 12317 Soaring Flight Dr , Jacksonville FL 32225-0784. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Watson, Kelly Conway can be contacted via phone (904) 881-8677.

Contact Information

Primary practice address
12317 Soaring Flight Dr Jacksonville FL 32225-0784
Phone: (904) 881-8677
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X ARNP9348566 Florida

Profile Details

NPI number 1629447552
LBN Legal business name Watson, Kelly Conway
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 22nd, 2015
Last updated Nov 23rd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629447552 NPPES
Georgia MEDICAID 003169318A
Georgia MEDICAID 015846600

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