Provider Demographics
NPI:1609626621
Name:WATKINS, SUSAN RENEE (MIDWIFE)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:RENEE
Last Name:WATKINS
Suffix:
Gender:F
Credentials:MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8161 HAZEL DELL RD
Mailing Address - Street 2:
Mailing Address - City:HOWARD
Mailing Address - State:OH
Mailing Address - Zip Code:43028-9717
Mailing Address - Country:US
Mailing Address - Phone:614-561-2642
Mailing Address - Fax:
Practice Address - Street 1:8161 HAZEL DELL RD
Practice Address - Street 2:
Practice Address - City:HOWARD
Practice Address - State:OH
Practice Address - Zip Code:43028-9717
Practice Address - Country:US
Practice Address - Phone:614-561-2642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife