| Nikki D Watson, CRNA | |
|
701 N 1st St, Springfield, IL 62781-0001 | |
| (217) 788-3000 | |
| Not Available |
| Full Name | Nikki D Watson |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 701 N 1st St, Springfield, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669031530 | NPI | - | NPPES |
| 041-421740 | Other | IL | RN LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 209019517 (Illinois) | Primary |
| Entity Name | Iredell Memorial Hospital, Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548230204 PECOS PAC ID: 0648175927 Enrollment ID: O20040305000537 |
| Entity Name | Lake Norman Anesthesia Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386753457 PECOS PAC ID: 1951396126 Enrollment ID: O20040416001309 |
| Mailing Address | Practice Location Address |
|---|---|
| Nikki D Watson, CRNA Po Box 3428, Springfield, IL 62708-3428 Ph: (217) 588-2624 | Nikki D Watson, CRNA 701 N 1st St, Springfield, IL 62781-0001 Ph: (217) 788-3000 |
Douglas Mcdonald Childs, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 800 E Carpenter St, Springfield, IL 62704 Phone: 217-525-5643 Fax: 217-544-2521 | |
Carol A Gorden, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St, Springfield, IL 62781 Phone: 217-788-3754 Fax: 217-788-7071 | |
Ann R Larson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St, Anesthesia Department, Springfield, IL 62781 Phone: 217-788-3754 Fax: 217-788-7071 | |
Jenna Younker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 E Carpenter St, Springfield, IL 62702 Phone: 217-525-5643 Fax: 217-544-2521 | |
Kelsey A Wallace, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St, Springfield, IL 62781 Phone: 217-788-3000 | |
Delores A Gallo, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1025 S 6th St, Springfield, IL 62703 Phone: 217-528-7541 | |
Larry D. Sartore, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 800 East Carpenter Street, Room 2k64, Springfield, IL 62769 Phone: 217-525-5643 Fax: 217-544-3311 |