Provider Demographics
NPI:1487941084
Name:WATSON, CHERI (CCN, RH(AHG))
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:CCN, RH(AHG)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 DOUNCE ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2504
Mailing Address - Country:US
Mailing Address - Phone:303-931-3353
Mailing Address - Fax:678-261-5930
Practice Address - Street 1:700 DOUNCE ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2504
Practice Address - Country:US
Practice Address - Phone:303-931-3353
Practice Address - Fax:678-261-5930
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist