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Individual

DR. CRISTYN WATKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5001 LAKE AVE, SAINT JOSEPH, SAINT JOSEPH, MO 64504-1170
(816) 238-7788
(816) 238-9285
Mailing address
5001 LAKE AVE, SAINT JOSEPH, SAINT JOSEPH, MO 64504-1170
(816) 238-7788
(816) 238-9285

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
04-33784
KS
207Q00000X
Family Medicine Physician
Primary
2009016625
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790942910
MO
05
200614390A
KS
Enumeration date
05/16/2008
Last updated
06/01/2010
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