Provider Demographics
NPI:1497408421
Name:WATKINS, MERRY JANE
Entity Type:Individual
Prefix:MS
First Name:MERRY
Middle Name:JANE
Last Name:WATKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MERRY
Other - Middle Name:
Other - Last Name:WATKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1907 SIMMONS LN
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-5347
Mailing Address - Country:US
Mailing Address - Phone:404-514-1197
Mailing Address - Fax:
Practice Address - Street 1:1907 SIMMONS LN
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-5347
Practice Address - Country:US
Practice Address - Phone:404-514-1197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-31
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider