Individual
KINYATTA WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
18665 APPOLINE ST, DETROIT, MI 48235-1316
(313) 452-4682
Mailing address
18665 APPOLINE ST, DETROIT, MI 48235-1316
(313) 452-4682
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703122262
MI
Other
Enumeration date
10/04/2025
Last updated
10/22/2025
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