Provider Demographics
NPI:1881231686
Name:WATKINS, HEATHER ALYSE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ALYSE
Last Name:WATKINS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 TEDROW TRL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40342-8924
Mailing Address - Country:US
Mailing Address - Phone:502-598-9107
Mailing Address - Fax:
Practice Address - Street 1:610 E BRANNON RD STE 201
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-6046
Practice Address - Country:US
Practice Address - Phone:859-277-6516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-30
Last Update Date:2019-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily