Provider Demographics
NPI:1366569170
Name:WATTS, JOILITA DB
Entity type:Individual
Prefix:MRS
First Name:JOILITA
Middle Name:DB
Last Name:WATTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-5725
Mailing Address - Country:US
Mailing Address - Phone:513-557-6569
Mailing Address - Fax:513-261-9753
Practice Address - Street 1:1103 14TH AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-5725
Practice Address - Country:US
Practice Address - Phone:513-557-6569
Practice Address - Fax:513-261-9753
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2200764Medicaid