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NPI Code Detail

MEDICARE: MRS. LYNN HARTOUGH WATKINS FNP-C

MEDICARE: MRS. LYNN HARTOUGH WATKINS FNP-C
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
1363LP0200XPediatric Nurse Practitioner0024172657VA
2363LF0000XFamily Nurse Practitioner0024172657VA

General Provider Information

NPI Number : 1417338831
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LYNN HARTOUGH WATKINS FNP-C
Provider Business Mailing Address
First Line : 5000 MONUMENT AVE FL 2
Second Line :
City : RICHMOND
State : VA
Zip : 23230-3627
Country : US
Telephone Number : 804-269-8291
Fax Number : 804-269-8293
Provider Business Practice Location Address
First Line : 5000 MONUMENT AVE FL 2
Second Line :
City : RICHMOND
State : VA
Zip : 23230-3627
Country : US
Telephone Number : 804-269-8291
Fax Number : 804-269-8293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2015
Last Update Date : 12/23/2024

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