Provider Demographics
NPI:1508091083
Name:WATKINS, CHANIN
Entity Type:Individual
Prefix:
First Name:CHANIN
Middle Name:
Last Name:WATKINS
Suffix:
Gender:F
Credentials:
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 571
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:GA
Mailing Address - Zip Code:30620-0571
Mailing Address - Country:US
Mailing Address - Phone:678-935-0231
Mailing Address - Fax:678-935-0363
Practice Address - Street 1:1664 DILLARD WAY
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:GA
Practice Address - Zip Code:30620-2598
Practice Address - Country:US
Practice Address - Phone:678-935-0231
Practice Address - Fax:678-935-0363
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information