Provider Demographics
NPI:1992471239
Name:WATSON, MEGAN NICOLE (PHARMD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
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 1:13201 RITTENHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-6245
Mailing Address - Country:US
Mailing Address - Phone:804-763-5403
Mailing Address - Fax:804-763-5407
Practice Address - Street 1:13201 RITTENHOUSE DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-6245
Practice Address - Country:US
Practice Address - Phone:804-763-5403
Practice Address - Fax:804-763-5407
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022197241835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist