Provider Demographics
NPI:1376979369
Name:WATKINS, SHARMETRIS K (NP)
Entity Type:Individual
Prefix:MRS
First Name:SHARMETRIS
Middle Name:K
Last Name:WATKINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-542-0744
Mailing Address - Fax:704-543-7713
Practice Address - Street 1:15830 BALLANTYNE MEDICAL PL
Practice Address - Street 2:SUITE 275
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4653
Practice Address - Country:US
Practice Address - Phone:704-542-0744
Practice Address - Fax:704-543-7713
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5006426363LW0102X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health