Individual
NICOLE LYNN WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4200B TECHNOLOGY CT, CHANTILLY, VA 20151-1214
(703) 988-3984
(703) 988-7530
Mailing address
4200B TECHNOLOGY CT, CHANTILLY, VA 20151-1214
(703) 988-3984
(703) 988-7530
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001219226
VA
163W00000X
Registered Nurse
RN1011818
DC
163W00000X
Registered Nurse
RN9325226
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024171495
VA
367500000X
Certified Registered Nurse Anesthetist
0024171495
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
049742400
—
DC
05
—
1063841971
—
VA
05
—
422488400
—
MD
Enumeration date
11/01/2013
Last updated
02/06/2026
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