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Individual
DOUGLAS LEE WATSON
Active
Individual
DOUGLAS LEE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
1030062854
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71013479A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300010664
—
IN
05
—
7100535740
—
KY
01
—
IN3604
MEDICARE
IN
01
—
K258180
MEDICARE
KY
Enumeration date
08/09/2022
Last updated
01/22/2025
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