Provider Demographics
NPI:1316777196
Name:WATSON, BROOKLYNN KARIN (PHARMD)
Entity type:Individual
Prefix:
First Name:BROOKLYNN
Middle Name:KARIN
Last Name:WATSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W4047 COUNTY ROAD C
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:WI
Mailing Address - Zip Code:53570-9727
Mailing Address - Country:US
Mailing Address - Phone:815-980-1675
Mailing Address - Fax:
Practice Address - Street 1:515 22ND AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-1569
Practice Address - Country:US
Practice Address - Phone:608-324-2259
Practice Address - Fax:608-324-1131
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22722-401835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care