Provider Demographics
NPI:1699587063
Name:WATSON, BRITT COLLEEN (RN)
Entity type:Individual
Prefix:
First Name:BRITT
Middle Name:COLLEEN
Last Name:WATSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BRITT
Other - Middle Name:COLLEEN
Other - Last Name:MASSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A-MAIDEN NAME
Mailing Address - Street 1:504 TUMBLEWEED DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-4604
Mailing Address - Country:US
Mailing Address - Phone:219-246-9920
Mailing Address - Fax:
Practice Address - Street 1:504 TUMBLEWEED DR
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-4604
Practice Address - Country:US
Practice Address - Phone:219-246-9920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28244578A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse