Basic Information
| Provider Information | |||||||||
| NPI: | 1053971689 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WATKINS | ||||||||
| FirstName: | CHELSEA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 CLINCH AVE STE 510 | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379162225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655463998 | ||||||||
| FaxNumber: | 8655461123 | ||||||||
| Practice Location | |||||||||
| Address1: | 2100 CLINCH AVE STE 510 | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379162225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655463998 | ||||||||
| FaxNumber: | 8655461123 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2019 | ||||||||
| LastUpdateDate: | 01/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 208100 | TN | N | Nursing Service Providers | Registered Nurse | 363LP0200X | 000026255 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.