Provider Demographics
NPI:1972170413
Name:WATSON, ALEXI PAIGE
Entity Type:Individual
Prefix:
First Name:ALEXI
Middle Name:PAIGE
Last Name:WATSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SIGOURNEY
Mailing Address - State:IA
Mailing Address - Zip Code:52591-1445
Mailing Address - Country:US
Mailing Address - Phone:641-680-2648
Mailing Address - Fax:
Practice Address - Street 1:110 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SIGOURNEY
Practice Address - State:IA
Practice Address - Zip Code:52591-1445
Practice Address - Country:US
Practice Address - Phone:641-680-2648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide