Provider Demographics
NPI:1457720849
Name:WATKINS, DONNA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
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 1:2 HERITAGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08501
Mailing Address - Country:US
Mailing Address - Phone:609-259-4386
Mailing Address - Fax:609-939-0699
Practice Address - Street 1:2 HERITAGE DRIVE
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08501
Practice Address - Country:US
Practice Address - Phone:609-259-4386
Practice Address - Fax:609-939-0699
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY272369-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse