Miss Koran B. Watson
Registered Dietitian in Philadelphia, PA(View on Map)
Full Name
Miss Koran Bianca Watson
NPI Number
1174162572
NPI Type
Individual Provider
Gender
Female
Enumeration Date
01/02/2020
Specialties
(Taxonomies)Licenses
State
Pennsylvania
Pennsylvania
License Number
DN0006020
DN006020
Contact
Information
Purpose
Mailing
Location
Address
21 S 11TH ST
21 S 11TH ST
City
Philadelphia
Philadelphia
State
PA
PA
Postal Code
19107-4223
19107-4223
Country
US
US
Telephone Number
(267) 209-3245
(267) 209-3245
Identifiers
Identifier
DN006020
Identifier State
PA
Identifier Issuer
PA NURSING BROAD
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/12/2022