Provider Demographics
NPI:1174167639
Name:WATSON CONDUAH, NICOLA NATALIE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:NICOLA
Middle Name:NATALIE
Last Name:WATSON CONDUAH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:NICOLA
Other - Middle Name:NATALIE
Other - Last Name:WATSON CONDUAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:PO BOX 4232
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30023-4232
Mailing Address - Country:US
Mailing Address - Phone:678-860-8844
Mailing Address - Fax:
Practice Address - Street 1:2320 ATLANTA HWY STE 105
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-6339
Practice Address - Country:US
Practice Address - Phone:678-860-8844
Practice Address - Fax:770-886-9908
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-29
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN250366363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily