Individual
DR. BRANDI LYNN WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, NNP-BC
Contact information
Practice address
2325 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 557-2700
Mailing address
4580 LONG BOW BND, IDAHO FALLS, ID 83406-4935
(208) 681-2610
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
8361274
ID
363LN0005X
Critical Care Neonatal Nurse Practitioner
8361274
ID
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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