=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619569456
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NICOLE AMY WATSON PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2021
-----------------------------------------------------
Last Update Date | 12/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5340 S QUEBEC ST STE 310S
-----------------------------------------------------
City | GREENWOOD VILLAGE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80111-1906
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-773-4771
-----------------------------------------------------
Fax | 720-414-1530
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5340 S QUEBEC ST STE 310S
-----------------------------------------------------
City | GREENWOOD VILLAGE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80111-1906
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-773-4771
-----------------------------------------------------
Fax | 720-414-1530
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | APN.0996230-NP
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------