Individual
KRISTAL DENISE WATKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
12 DALE AVE APT D10, PATERSON, NJ 07505-1936
(804) 647-2352
Mailing address
12 DALE AVE APT D10, PATERSON, NJ 07505-1936
(804) 647-2352
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
2073714
VA
164W00000X
Licensed Practical Nurse
Primary
314346
NY
Other
Enumeration date
09/27/2013
Last updated
05/28/2014
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