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NPI Code Detail

MEDICARE: MRS. MACKENZIE DAY WATKINS NP

MEDICARE: MRS. MACKENZIE DAY WATKINS NP
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
1363LW0102XWomen's Health Nurse Practitioner940090NC
2363L00000XNurse Practitioner940090NC
3163WW0101XAmbulatory Women's Health Care Registered Nurse182417NC

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 : 1184623415
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MACKENZIE DAY WATKINS NP
Provider Business Mailing Address
First Line : PO BOX 751803
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1803
Country : US
Telephone Number : 336-722-1818
Fax Number : 336-722-1826
Provider Business Practice Location Address
First Line : 2001 TODAYS WOMAN AVE
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27105-5069
Country : US
Telephone Number : 336-722-1818
Fax Number : 336-722-1826
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 11/27/2023

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