Individual
LEANNE Y WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1350 PARKWAY, GREENWOOD, SC 29646-3860
(864) 330-1800
Mailing address
PO BOX 50087, GREENWOOD, SC 29649-0019
(864) 330-1800
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
3199
SC
363LF0000X
Family Nurse Practitioner
Primary
F3199
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK1161
MEDICARE RR
SC
05
—
NP1121
—
SC
Enumeration date
06/20/2007
Last updated
05/24/2011
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