Individual
ANGELA LAVERNE WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22250 PROVIDENCE DR STE 406, SOUTHFIELD, MI 48075-6212
(248) 557-9010
(248) 557-3655
Mailing address
17030 CARRIAGE WAY, NORTHVILLE, MI 48168-6602
(313) 949-2620
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704222141
MI
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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