Provider Demographics
NPI:1801351416
Name:WATKINS, DAVEY VIRGINIA
Entity type:Individual
Prefix:
First Name:DAVEY
Middle Name:VIRGINIA
Last Name:WATKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 WALLACE LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2306
Mailing Address - Country:US
Mailing Address - Phone:615-521-3256
Mailing Address - Fax:
Practice Address - Street 1:4027 HILLSBORO PIKE STE 801
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2734
Practice Address - Country:US
Practice Address - Phone:615-385-2201
Practice Address - Fax:615-383-8590
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00006405225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant