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General NPI Number Information
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NPI Number | 1295064665
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Entity Type | Individual
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Provider Name | TREVOR WATSON MSN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 1217 RIVERSIDE AVE
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City | FORT COLLINS
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State | CO
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Zip | 80524-3218
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Country | US
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Telephone | 970-494-4200
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Fax | 970-221-7114
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Provider Business Mailing Address
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Address Line | 4856 INNOVATION DR STE B
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City | FORT COLLINS
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State | CO
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Zip | 80525-5540
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Country | US
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Telephone | 970-494-4200
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Fax | 970-613-4475
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.1664145
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APN.0994999-NP
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License Number State | CO
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