Provider Demographics
NPI:1851813141
Name:WATT, SAMANTHA LYNN (APRN)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:LYNN
Last Name:WATT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-377-9268
Mailing Address - Fax:501-367-7790
Practice Address - Street 1:5700 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3328
Practice Address - Country:US
Practice Address - Phone:501-377-9268
Practice Address - Fax:501-367-7790
Is Sole Proprietor?:No
Enumeration Date:2017-07-09
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005252363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology