Provider Demographics
NPI:1679808547
Name:WATKINS, CATHY J (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:J
Last Name:WATKINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3728 N PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-9744
Mailing Address - Country:US
Mailing Address - Phone:575-769-2389
Mailing Address - Fax:575-769-2768
Practice Address - Street 1:3728 N PRINCE ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-9744
Practice Address - Country:US
Practice Address - Phone:575-769-2389
Practice Address - Fax:575-769-2768
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRPH0004872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist