Individual
MRS. HOLLI WATKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1601 MONMOUTH ST STE 100, INDEPENDENCE, OR 97351-1019
(503) 838-0045
Mailing address
10210 BELLINGHAM DR, SUMMERSET, SD 57718-9271
(605) 890-2517
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201909639NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500772076
—
OR
Enumeration date
10/29/2012
Last updated
03/07/2023
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