Provider Demographics
NPI:1083448930
Name:WATKINS, SHARON DANETTE
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:DANETTE
Last Name:WATKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 LAWFIN ST W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-6337
Mailing Address - Country:US
Mailing Address - Phone:904-403-7680
Mailing Address - Fax:
Practice Address - Street 1:1044 LAWFIN ST W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-6337
Practice Address - Country:US
Practice Address - Phone:904-403-7680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL222990251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health