Provider Demographics
NPI:1982134185
Name:WATKINS, CYNTHIA ELLEN
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ELLEN
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 1:1607 WIND HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-3646
Mailing Address - Country:US
Mailing Address - Phone:405-365-4345
Mailing Address - Fax:405-321-1238
Practice Address - Street 1:317 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-1312
Practice Address - Country:US
Practice Address - Phone:405-321-1231
Practice Address - Fax:405-321-1328
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator