Individual
JO ANNA WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
Mailing address
PO BOX 422, PUEBLO, CO 81002-0422
(719) 331-1773
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0005711
CO
Other
Enumeration date
01/30/2019
Last updated
01/30/2019
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