Provider Demographics
NPI:1821881848
Name:WATKINS, KARYSSA KARINE
Entity type:Individual
Prefix:
First Name:KARYSSA
Middle Name:KARINE
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 1:357 W UNION ST APT 4
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1854
Mailing Address - Country:US
Mailing Address - Phone:330-242-6156
Mailing Address - Fax:
Practice Address - Street 1:357 W UNION ST APT 4
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1854
Practice Address - Country:US
Practice Address - Phone:330-242-6156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide