Watkins, Maryjo A

Watkins, Maryjo A is an individual health care provider with primary practice located at 155 Memorial Dr Anesthesia Dept, Pinehurst NC 28374-8710. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Watkins, Maryjo A can be contacted via phone (910) 715-1235.

Contact Information

Primary practice address
155 Memorial Dr Anesthesia Dept Pinehurst NC 28374-8710
Phone: (910) 715-1235
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 10681 Tennessee

Profile Details

NPI number 1285628461
LBN Legal business name Watkins, Maryjo A
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285628461 NPPES
Tennessee MEDICAID 3627252
Tennessee Other 00013859
Tennessee Other 4053056
Tennessee Other 278219
Tennessee Other TN0100
Tennessee MEDICAID 74005992

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