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NPI Code Detail

MEDICARE: LINDSEY BREANNE WATKINS

MEDICARE:   LINDSEY BREANNE WATKINS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner95011860CA

General Provider Information

NPI Number : 1265090997
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY BREANNE WATKINS
Provider Business Mailing Address
First Line : 24022 LEEWARD DR
Second Line :
City : DANA POINT
State : CA
Zip : 92629-4454
Country : US
Telephone Number : 661-213-6335
Fax Number :
Provider Business Practice Location Address
First Line : 23961 CALLE DE LA MAGDALENA STE 405
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-3683
Country : US
Telephone Number : 949-588-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2019
Last Update Date : 05/29/2019

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Directions to “ LINDSEY BREANNE WATKINS ” Practice Location

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