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NPI Code Detail

MEDICARE: SANDRA DENISE WATKINS LPN

MEDICARE:   SANDRA DENISE WATKINS  LPN
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
1164W00000XLicensed Practical Nurse303146-31WI

General Provider Information

NPI Number : 1770866584
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA DENISE WATKINS LPN
Provider Business Mailing Address
First Line : 4206 N 92ND ST APT 2
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-1637
Country : US
Telephone Number : 414-793-0880
Fax Number :
Provider Business Practice Location Address
First Line : 4206 N 92ND ST APT 2
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-1637
Country : US
Telephone Number : 414-793-0880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2011
Last Update Date : 09/28/2011

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Directions to “ SANDRA DENISE WATKINS LPN” Practice Location

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