Individual
TAYLOR WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1663 BELVIDERE RD, BELVIDERE, IL 61008-9306
(815) 544-0040
Mailing address
1112 TORINO LN, FRANKLIN, IN 46131-7057
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.008217
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2020
Last updated
02/22/2021
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