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General NPI Number Information
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NPI Number | 1609050285
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Entity Type | Individual
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Provider Name | ELIZABETH ANN WATKINS NP
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Gender | Female
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | 2000 MEADE PKWY
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City | SUFFOLK
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State | VA
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Zip | 23434
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Country | US
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Telephone | 757-539-0251
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Fax | 757-934-2564
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Provider Business Mailing Address
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Address Line | 2800 GODWIN BLVD FL 1
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City | SUFFOLK
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State | VA
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Zip | 23434-8038
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Country | US
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Telephone | 757-934-4821
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Fax | 757-934-4276
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001135090
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024164203
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License Number State | VA
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