Provider Demographics
NPI:1114763141
Name:WATKINS, KHAARON MICHAEL
Entity type:Individual
Prefix:
First Name:KHAARON
Middle Name:MICHAEL
Last Name:WATKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 RTE 9 SOUTH
Mailing Address - Street 2:PO BOX 437
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08252
Mailing Address - Country:US
Mailing Address - Phone:202-819-7059
Mailing Address - Fax:
Practice Address - Street 1:2008 SOUTH ROUTE 9
Practice Address - Street 2:
Practice Address - City:MIDDLE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08252
Practice Address - Country:US
Practice Address - Phone:202-819-7059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide