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Individual

FANNIE FAYE WATKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA-LICENSE

Contact information

Practice address
3272 VALLEY STREAM CO, MEMPHIS, TN 38128
(901) 282-2706
Mailing address
P.O. BOX 281375, MEMPHIS, TN 38168-1375
(901) 282-2706

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
126228
TN

Other

Enumeration date
08/31/2010
Last updated
08/31/2010
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