Mary Lucille Watson
Nurse Practitioner - Neonatal (Critical Care)
1465 S Grand Blvd
Saint Louis
, Missouri 63104-1003
Mary Lucille Watson
Nurse Practitioner - Neonatal (Critical Care)
1465 S Grand Blvd
Saint Louis
, Missouri 63104-1003
(314) 984-9084
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About
Features
Specialties
- Nurse Practitioner - Neonatal (Critical Care)
Languages spoken
- English
Location
First Address
- Mary Lucille Watson
- 12862 Whitehorse Ln
- Des Peres, MO
- Zip : 63131-2239
- Phone : (314) 984-9084
Second Address
- Mary Lucille Watson
- 1465 S Grand Blvd
- Saint Louis, MO
- Zip : 63104-1003
- Phone : (314) 577-5631
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 96751 | MO |
National Provider Identifier
| NPI | 1235344276 |
|---|---|
| Provider Name | Mary Lucille Watson |
| First Address | Des Peres, MO 63131-2239 |
| Second Address | Saint Louis, MO 63104-1003 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/05/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.