Individual
KATELYN MARIE WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2001 VAIL AVE STE 200, CHARLOTTE, NC 28207-1222
(704) 323-3668
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-2237
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-10914
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659960847
—
NC
05
—
5150PA
—
SC
Enumeration date
01/13/2021
Last updated
05/26/2022
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