Individual provider Active NPI

Brielle Watson

  • Registered Nurse
  • Florissant, MO
National Provider Identifier
1972372498
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2020001605 Issued in MO
Practice address
1440 Burnside CT
Florissant, MO 63031-1103
Phone
(314) 791-3493
NPI assigned
Dec 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2020001605 MO Primary

Addresses

Primary practice location

1440 Burnside CT
Florissant, MO 63031-1103

Mailing address

1440 Burnside CT
Florissant, MO 63031-1103

Other practice location 1

3121 Diablo Ave
Hayward, CA 94545-2701
Phone (855) 910-8606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2020001605MOMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1703548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1972372498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 BURNSIDE CT",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630311103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 BURNSIDE CT",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630311103",
            "telephone_number": "314-791-3493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3121 Diablo Ave",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "CA",
            "postal_code": "945452701",
            "country_code": "US",
            "telephone_number": "855-910-8606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "BRIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-26",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2020001605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.