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Individual

SANDRA TINA WATKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1061 HARMON AVE STE 1D03, FORT STEWART, GA 31314-5641
(912) 435-6303
(912) 435-7089
Mailing address
15 E KENNY DR, HINESVILLE, GA 31313-8730
(912) 977-2040
(912) 435-7989

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN069489
GA

Other

Enumeration date
09/15/2014
Last updated
09/15/2014
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