MRS. DEITRA MECHELLE WATSON (NPI# 1285869578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285869578 |
| Entity Type | Individual |
| Full Name | MRS. DEITRA MECHELLE WATSON |
| Credential | MSN, APRN-BC |
| Practice Address |
1853 Greenwyche Ave Columbia SC 29210-6123 |
| Practice Telephone | 8037310069 |
| Mailing Telephone | 8037310069 |
| Mailing Fax Number | 8037310069 |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2009-05-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3842 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437345402 | Deitra Ann Watson | Prosthetist | 1011 18th St N, 2b, Fargo, ND 58102-3238 | 2007-09-24 |
| Street Address |
1853 GREENWYCHE AVE |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29210-6123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700413838 | Alexis Koreema Brown | Social Worker | 3205 Montcrest Rd., Columbia, SC 29210 | 2020-03-26 |
| 1942767843 | Thomas Edwin Cromer | Social Worker | 409 Evelyn Drive, Columbia, SC 29210 | 2019-02-27 |
| 1184193542 | Helen Hoffman Coleman | Pharmacist | 16 Berryhill Road, Ste 109, Columbia, SC 29210 | 2018-11-15 |
| 1356828040 | Latia Kelly Mcdonald | Counselor | 105 Beth Hope Lane, Columbia, SC 29210 | 2018-07-25 |
| 1356892848 | Butterfly Effects LLC | Community/Behavioral Health | 1607 Bentley Court, Columbia, SC 29210 | 2016-10-19 |
| 1114373651 | Lilian Emetu | Nurse Practitioner | 822 Statler Road, Columbia, SC 29210 | 2016-05-13 |
| 1154776433 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 507 Piney Grove Rd, Columbia, SC 29210 | 2016-04-25 |
| 1790167690 | Wanda Al-lahabi | Specialist | 1030 St. Andrews Rd., Suite B-3, Columbia, SC 29210 | 2015-06-26 |
| 1285040279 | Debra R. Smart | Counselor | 652 Bush Road, Suite 216, Columbia, SC 29210 | 2014-07-10 |
| 1144665282 | Snf Transportation LLC | Home Health | 810 Dutch Center Blvd, Columbia, SC 29210 | 2013-05-02 |
| Find all providers in zip 29210 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114526266 | Leslie Desha | Nurse Practitioner | 1109 Pheasant Run, Columbia, MO 65201-6253 | 2020-10-20 |
| 1407454101 | Jason D Jones | Nurse Practitioner | 213 Austell Dr, Columbia, TN 38401-5531 | 2020-10-14 |
| 1316544315 | Rezvaneh Goodarzi | Nurse Practitioner | 8830 Tamar Dr Apt 301, Columbia, MD 21045-2962 | 2020-10-03 |
| 1316559255 | Lauren Olivia Lenauer | Nurse Practitioner | 1600 E Broadway # 300, Columbia, MO 65201-5844 | 2020-08-21 |
| 1285246272 | Lourdes Claire De Las Alas | Nurse Practitioner | 6005 Shepherd Sq, Columbia, MD 21044-3114 | 2020-08-20 |
| 1619587540 | Josey Abraham | Nurse Practitioner | 305 Aiken Hunt Cir, Columbia, SC 29223-8407 | 2020-08-05 |
| 1588274765 | Tomeka Nichole Jackson | Nurse Practitioner | 6156 Saint Andrews Rd Ste 208, Columbia, SC 29212-3147 | 2020-08-03 |
| 1528696762 | Mark Edward Merkel | Nurse Practitioner | 1040 N James M Campbell Blvd, Columbia, TN 38401-2756 | 2020-04-01 |
| 1306489265 | Andrew Leitch | Nurse Practitioner | 313 N Trenholm Rd, Columbia, SC 29206-3207 | 2019-10-23 |
| 1760033476 | Emily Smith | Nurse Practitioner | 157 Chinquapin Cir, Columbia, SC 29212-2902 | 2019-09-24 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.