Basic Information
Provider Information
NPI: 1750612370
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WATKINS
FirstName: SHERI
MiddleName: KAY
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1278 N LAFAYETTE DR
Address2:  
City: SUMTER
State: SC
PostalCode: 291502964
CountryCode: US
TelephoneNumber: 8037744500
FaxNumber: 8037744641
Practice Location
Address1: 1278 N LAFAYETTE DR
Address2:  
City: SUMTER
State: SC
PostalCode: 291502964
CountryCode: US
TelephoneNumber: 8037744500
FaxNumber: 8037744641
Other Information
ProviderEnumerationDate: 01/21/2010
LastUpdateDate: 02/11/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102X107SCN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
367A00000XWH107SCY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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