Individual
WANDA WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
711 E MISSOURI AVE, PHOENIX, AZ 85014-2841
(602) 433-1200
Mailing address
711 E MISSOURI AVE, PHOENIX, AZ 85014-2841
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP010044
AZ
Other
Enumeration date
12/03/2015
Last updated
12/03/2015
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