Provider Demographics
NPI:1922385335
Name:WATKINS, ISHEKA (FNP)
Entity Type:Individual
Prefix:
First Name:ISHEKA
Middle Name:
Last Name:WATKINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 WHITE PLAINS RD
Mailing Address - Street 2:SOUNDVIEW HEALTHCARE NETWORK
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2631
Mailing Address - Country:US
Mailing Address - Phone:718-589-2232
Mailing Address - Fax:718-378-2880
Practice Address - Street 1:731 WHITE PLAINS RD
Practice Address - Street 2:SOUNDVIEW HEALTHCARE NETWORK
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2631
Practice Address - Country:US
Practice Address - Phone:718-589-8775
Practice Address - Fax:718-328-5082
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336205363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03441747Medicaid