Individual
TINA WATHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1694 TROY RD, WASHINGTON, IN 47501-8216
(812) 254-3800
(812) 254-3801
Mailing address
202 E WASHINGTON ST, LOOGOOTEE, IN 47553-2107
(812) 709-9391
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27054511A
IN
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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