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NPI Code Detail

MEDICARE: MRS. MARILYN F WATKINS CFNP

MEDICARE: MRS. MARILYN F WATKINS CFNP
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
1163W00000XRegistered Nurse28048263AIN
2363LF0000XFamily Nurse Practitioner71000756AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023101953
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARILYN F WATKINS CFNP
Provider Business Mailing Address
First Line : 120 W 22ND ST STE 200
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1563
Country : US
Telephone Number : 630-573-5000
Fax Number :
Provider Business Practice Location Address
First Line : 7836 W JEFFERSON BLVD STE 101
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4178
Country : US
Telephone Number : 260-494-3484
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 04/25/2025

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