Provider Demographics
NPI:1275913204
Name:WATKINS, SHARIA (LPN)
Entity Type:Individual
Prefix:
First Name:SHARIA
Middle Name:
Last Name:WATKINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-5705
Mailing Address - Country:US
Mailing Address - Phone:609-396-4557
Mailing Address - Fax:609-396-8420
Practice Address - Street 1:10 SOUTHARD ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08609-1020
Practice Address - Country:US
Practice Address - Phone:609-396-4557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP06796900164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse