Provider Demographics
NPI:1336319482
Name:WATKINS, ALISON L (MMS PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:L
Last Name:WATKINS
Suffix:
Gender:F
Credentials:MMS PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:6252 YELLOWSTONE RD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-3432
Practice Address - Country:US
Practice Address - Phone:307-778-2015
Practice Address - Fax:307-778-7060
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY435363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10027099700Medicaid
CO1688OtherLICENSE
WY435OtherWY LIC 435
WYW33945OtherMEDICARE
NE10027099703Medicaid
CO2D4405OtherMEDICARE
NE10027099702Medicaid
WY142755500Medicaid