Watters, Nicholas

Watters, Nicholas is an individual health care provider with primary practice located at 240 W Dixie, Suite 5-B, Elizabethtown KY 42701-1575. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Watters, Nicholas can be contacted via phone (270) 401-4107.

Contact Information

Primary practice address
240 W Dixie, Suite 5-B Elizabethtown KY 42701-1575
Phone: (270) 401-4107
Fax: (270) 209-0872
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1492 Kentucky

Profile Details

NPI number 1063468817
LBN Legal business name Watters, Nicholas
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2006
Last updated May 31st, 2016 - about 9 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 1063468817 NPPES
Other 11574941 CAQH
MEDICAID 7100266120 CAQH

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