Healthcare Provider Details

I. General information

NPI: 1922605732
Provider Name (Legal Business Name): BRITTANY D WATSON DNP, APRN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 11/27/2020
Certification Date: 11/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W RAHN RD
KETTERING OH
45429-2219
US

IV. Provider business mailing address

33 W RAHN RD
KETTERING OH
45429-2219
US

V. Phone/Fax

Practice location:
  • Phone: 937-433-8990
  • Fax: 937-433-8691
Mailing address:
  • Phone: 937-433-8990
  • Fax: 937-433-8691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0027678
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: