MEDICARE: WATSON PSYCHIATRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1992426787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WATSON PSYCHIATRY LLC

Provider Business Mailing Address
First Line	:	5340 S QUEBEC ST STE 310S
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-1906
Country	:	US
Telephone Number	:	720-773-4771
Fax Number	:	720-414-1530

Provider Business Practice Location Address
First Line	:	5340 S QUEBEC ST STE 310S
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-1906
Country	:	US
Telephone Number	:	720-773-4771
Fax Number	:	720-414-1530

Authorized Official
Title or Position	:	PHMNP-BC
Name	:	NICOLE AMY WATSON
Credential	:	PMHNP-BC
Telephone Number	:	720-773-4771

Provider Enumeration Date	:	09/08/2022
Last Update Date	:	12/31/2025

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