Krystyna Watson

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703125798 Issued in MI

Practice address

5300 Patterson Ave SE Ste 125
Grand Rapids, MI 49512-9627

Phone

(616) 222-5601

NPI assigned

Aug 4, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1659008118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 NILES BUCHANAN RD",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491203503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 PATTERSON AVE SE STE 125",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495129627",
            "telephone_number": "616-222-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KRYSTYNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703125798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Jean Watson, PA-C
• Emily Anne Watson
• Erin Kathleen Watson, LMSW
• Jennifer J. Watson, M.D.
• Jordan Mariah Watson
• Leah Dream Watson
• Lisa Watson, MA, LPC
• Nicholas C. Watson, MD
• Shaun Watson
• Stacey Watson, M.S.

• Licensed Practical Nurse in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.