Individual
MISTY SHELLETTE WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 WOODCREEK DR, LA GRANGE, KY 40031-9000
(502) 222-7938
(502) 265-9092
Mailing address
660 POLLITT CIR, NEW CASTLE, KY 40050-6770
(502) 321-3293
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/20/2025
Last updated
08/20/2025
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