Individual provider · Type 1 NPI

Jefferson Waters

Student in an Organized Health Care Education/Training Program · Wilkes Barre, PA

NPI number 1003756289 Active

Practice location

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027

Call (570) 808-7300 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1003756289

Jefferson Waters's National Provider Identifier is 1003756289, issued on Mar 30, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Wilkes Barre, PA. The record was last updated on Mar 30, 2026.