Provider Demographics
NPI:1508166109
Name:WATKINS, ROCHELLE KATHRYN (CNP)
Entity Type:Individual
Prefix:MRS
First Name:ROCHELLE
Middle Name:KATHRYN
Last Name:WATKINS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MRS
Other - First Name:ROCHELLE
Other - Middle Name:KATHRYN
Other - Last Name:JERNEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:1483 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371-2803
Mailing Address - Country:US
Mailing Address - Phone:937-667-7713
Mailing Address - Fax:937-667-8067
Practice Address - Street 1:1483 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-2803
Practice Address - Country:US
Practice Address - Phone:937-667-7713
Practice Address - Fax:937-667-8067
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-07918363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics