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Individual

MRS. MARILYN F WATKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
7836 W JEFFERSON BLVD STE 101, FORT WAYNE, IN 46804-4178
(260) 494-3484
Mailing address
120 W 22ND ST STE 200, OAK BROOK, IL 60523-1563
(630) 573-5000

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28048263A
IN
363LF0000X
Family Nurse Practitioner
Primary
71000756A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200308160
IN
Enumeration date
10/02/2006
Last updated
04/25/2025
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