NICOLE LYNN WATSON CRNA NPI 1063841971

NPI Information

  • NPI: 1063841971
  • Provider Name: NICOLE LYNN WATSON, CRNA
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4200B TECHNOLOGY CT
    CHANTILLY, VA
    ZIP 20151
  • Phone: (703) 988-3984

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NPI Details

Nicole Lynn Watson, CRNA is a psychiatric/mental health nurse practitioner in Chantilly, VA. Nicole Lynn Watson, CRNA NPI is 1063841971. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4200B TECHNOLOGY CT
CHANTILLY, VA
ZIP 20151-214
Phone: (703) 988-3984

The NPI 1063841971 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/1/2013 and was last updated on 11/17/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1367500000XNurse Anesthetist, Certified Registered0024171495VIRGINIANo
2363LP0808XNurse PractitionerPsychiatric/Mental Health0024171495VIRGINIAYes
3163W00000XRegistered Nurse0001219226VIRGINIANo
4163W00000XRegistered NurseRN1011818DISTRICT OF COLUMBIANo
5163W00000XRegistered NurseRN9325226FLORIDANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11063841971MEDICAIDVIRGINIA
2422488400MEDICAIDMARYLAND
3049742400MEDICAIDDISTRICT OF COLUMBIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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