Individual
CHANNAE WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3229 BROADWAY STE 205, GARY, IN 46409-1038
(219) 806-3000
(219) 806-3024
Mailing address
128 S EAST ST UNIT 227, CROWN POINT, IN 46308-3418
(219) 791-3512
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71009132A
IN
Other
Enumeration date
07/12/2019
Last updated
11/25/2020
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