Provider Demographics
NPI:1861264913
Name:WATSON, EMILY MICHELE (PA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MICHELE
Last Name:WATSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 SPRING POINTE LN
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-6043
Mailing Address - Country:US
Mailing Address - Phone:615-516-5577
Mailing Address - Fax:
Practice Address - Street 1:40 ELMO DR
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-4807
Practice Address - Country:US
Practice Address - Phone:931-484-5525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical