Individual
MISS TEAGAN AUBREE WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3801 SPRING ST, MOUNT PLEASANT, WI 53405-1667
(262) 687-4060
Mailing address
3521 OAKWOOD DR, RACINE, WI 53406-5467
(262) 220-2272
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5745-23
WI
Other
Enumeration date
03/02/2022
Last updated
03/03/2022
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