Individual
JACQUELYN LEAH WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
722 LOUGHBOROUGH AVE, SAINT LOUIS, MO 63111-2732
(314) 833-4030
(314) 833-4031
Mailing address
2712 PIPERS CT, BELLEVILLE, IL 62221-3485
(636) 575-0582
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015040599
MO
Other
Enumeration date
11/06/2015
Last updated
07/21/2022
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