Healthcare Provider Details

I. General information

NPI: 1598683054
Provider Name (Legal Business Name): EDWINA GAIL WATKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 REESE HOLLOW RD
GALLIPOLIS OH
45631-8634
US

IV. Provider business mailing address

285 REESE HOLLOW RD
GALLIPOLIS OH
45631-8634
US

V. Phone/Fax

Practice location:
  • Phone: 937-672-8583
  • Fax:
Mailing address:
  • Phone: 937-672-8583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: