Individual
DESIREE LATORI WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3920 DUTCHMANS LN STE 315, LOUISVILLE, KY 40207-4702
(502) 367-4500
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 367-4500
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
3015841
KY
363LF0000X
Family Nurse Practitioner
Primary
3015841
KY
Other
Enumeration date
08/29/2023
Last updated
11/01/2023
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