Individual
MRS. ELYSE JAN WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2311 LEWISVILLE CLEMMONS RD, CLEMMONS, NC 27012-8905
(336) 713-0400
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102205
NC
363A00000X
Physician Assistant
PA13334
CA
Other
Enumeration date
09/12/2006
Last updated
11/16/2015
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