MEDICARE: MARSHA SUE WATSON LPN

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	164W00000X	Licensed Practical Nurse	23-23378-022	KS

General Provider Information

NPI Number	:	1538855127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARSHA SUE WATSON LPN

Provider Business Mailing Address
First Line	:	2200 SW GAGE BLVD
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66622-0002
Country	:	US
Telephone Number	:	866-484-8049
Fax Number	:	785-350-4704

Provider Business Practice Location Address
First Line	:	2200 SW GAGE BLVD
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66622-0002
Country	:	US
Telephone Number	:	866-484-8049
Fax Number	:	785-350-4704

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2023
Last Update Date	:	04/17/2023

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