MEDICARE: MARILYN WATKINS CRNP

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
1	363LA2200X	Adult Health Nurse Practitioner	VP002326C	PA

General Provider Information

NPI Number	:	1518050681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILYN WATKINS CRNP

Provider Business Mailing Address
First Line	:	1 CONVENTION AVE
Second Line	:	4 PENN TOWER
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4311
Country	:	US
Telephone Number	:	215-662-6488
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CONVENTION AVE
Second Line	:	4 PENN TOWER
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4311
Country	:	US
Telephone Number	:	215-662-6488
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	03/03/2014

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