Individual
JENNIFER WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-8166
Mailing address
3131 NEWMARK DR STE 220, MIAMISBURG, OH 45342-5400
(937) 436-4658
(937) 436-4984
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
COA.16430
OH
363LF0000X
Family Nurse Practitioner
Primary
COA.16430
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0113283
—
OH
Enumeration date
10/06/2014
Last updated
05/06/2020
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