Provider Demographics
NPI:1144733700
Name:WATSON, BRANDY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:
Other - Last Name:SCHLAGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:245 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48811-9650
Mailing Address - Country:US
Mailing Address - Phone:989-584-3272
Mailing Address - Fax:989-584-0541
Practice Address - Street 1:245 S 2ND ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:MI
Practice Address - Zip Code:48811-9650
Practice Address - Country:US
Practice Address - Phone:989-584-3272
Practice Address - Fax:989-584-0541
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302039579OtherPHARMACIST LICENSE
MI5315096730OtherCONTROLLED SUBSTANCE LICENSE