Provider Demographics
NPI:1134245343
Name:MARTIN-WATSON, BETTY (ANP-BC)
Entity type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:
Last Name:MARTIN-WATSON
Suffix:
Gender:
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27260-5017
Mailing Address - Country:US
Mailing Address - Phone:336-883-0029
Mailing Address - Fax:336-883-0867
Practice Address - Street 1:975 NC HIGHWAY 66 S
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3132
Practice Address - Country:US
Practice Address - Phone:336-883-0029
Practice Address - Fax:336-967-6685
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC075746163W00000X
NC900278363LF0000X, 363L00000X
NC102293363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC170XNOtherBCBS
NC6113029OtherMEDICAID NC - BEHAVORIAL HEALTH
NC7006380Medicaid
NCNC3783BMedicare PIN