Provider Demographics
NPI:1417338831
Name:WATKINS, LYNN HARTOUGH (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:HARTOUGH
Last Name:WATKINS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:LYNN
Other - Middle Name:CORNELIA
Other - Last Name:HARTOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5000 MONUMENT AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3627
Mailing Address - Country:US
Mailing Address - Phone:804-269-8291
Mailing Address - Fax:804-269-8293
Practice Address - Street 1:5000 MONUMENT AVE FL 2
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3627
Practice Address - Country:US
Practice Address - Phone:804-269-8291
Practice Address - Fax:804-269-8293
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172657363LP0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics