| Provider / Organization | NPI | Date Certified |
|---|---|---|
| HEATHER WATFORD | 1255805230 | 2022-07-30 |
Heather Lynette Watford [F] graduated in 2018 and primarily specializes in Nurse Practitioner.
Heather Watford is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1255805230. Registration indicates Heather Watford is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| PECOS ID | 7810327251 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Heather Watford |
| Practice Office Address | 130 PABLO ST LAKELAND, FL US |
| Practice Office Telephone | 8636876800 |
| Practice Office Fax | 8636871033 |
| Mailing Address | 6755 GALL BLVD ZEPHYRHILLS, FL 335422522 US |
| Business Telephone | 8637772740 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 3305 US Highway 98 S | Lakeland, FL 338038365 | 8637772740 |
| Direct Messaging Address [] | [email protected] | Direct |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 11000818
FL |