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NPI Code Detail

MEDICARE: CHELSEY KRISTYN WATSON CNP

MEDICARE: CHELSEY KRISTYN WATSON CNP
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
1363LF0000XFamily Nurse PractitionerCP001669SD

General Provider Information

NPI Number : 1548804990
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEY KRISTYN WATSON CNP
Provider Business Mailing Address
First Line : 3830 RED ROCK CANYON RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-4869
Country : US
Telephone Number : 605-680-2975
Fax Number :
Provider Business Practice Location Address
First Line : 4447 S CANYON RD STE 6
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-1889
Country : US
Telephone Number : 605-721-6426
Fax Number : 605-721-5515
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2019
Last Update Date : 10/29/2019

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