Healthcare Provider Details

I. General information

NPI: 1902949944
Provider Name (Legal Business Name): MELANIE ANNETTE WATSON PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N. MAIN ST.
EVANSVILLE IN
47711
US

IV. Provider business mailing address

10695 STATE ROUTE 120 E
SLAUGHTERS KY
42456-9598
US

V. Phone/Fax

Practice location:
  • Phone: 812-421-5871
  • Fax: 812-421-5864
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26021552A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number013041
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: