Provider Demographics
NPI:1255131835
Name:WATSON, NOVELYN GRACE
Entity type:Individual
Prefix:
First Name:NOVELYN
Middle Name:GRACE
Last Name:WATSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:NOVELYN
Other - Middle Name:GRACE
Other - Last Name:SCHIPMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:558 F ST
Mailing Address - Street 2:
Mailing Address - City:UNADILLA
Mailing Address - State:NE
Mailing Address - Zip Code:68454-4202
Mailing Address - Country:US
Mailing Address - Phone:402-875-3161
Mailing Address - Fax:
Practice Address - Street 1:558 F ST
Practice Address - Street 2:
Practice Address - City:UNADILLA
Practice Address - State:NE
Practice Address - Zip Code:68454-4202
Practice Address - Country:US
Practice Address - Phone:402-875-3161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant