Individual
NNENNA WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4915 MANOR DR, STONE MOUNTAIN, GA 30087-4128
(832) 923-6626
Mailing address
4915 MANOR DR, STONE MOUNTAIN, GA 30087-4128
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
DEPARTMENT OF VA
—
Enumeration date
08/20/2019
Last updated
08/20/2019
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