Individual
JUSTINE ANNISSA-MARIE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4755 OGLETOWN STANTON RD STE 5A43, NEWARK, DE 19718-2200
(302) 623-0188
(302) 733-5640
Mailing address
12251 S 80TH AVE STE 1520, PALOS HEIGHTS, IL 60463-1290
(708) 923-4200
(708) 923-4201
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085010236
IL
363A00000X
Physician Assistant
C5-0001071
DE
Other
Enumeration date
07/09/2015
Last updated
06/26/2024
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