Provider Demographics
NPI:1518752872
Name:WATKINS, JEANINE BOSTIC (LVN)
Entity type:Individual
Prefix:MRS
First Name:JEANINE
Middle Name:BOSTIC
Last Name:WATKINS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7626 MAYCREST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-6040
Mailing Address - Country:US
Mailing Address - Phone:210-969-7400
Mailing Address - Fax:210-590-1054
Practice Address - Street 1:6938 WALZEM RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-3641
Practice Address - Country:US
Practice Address - Phone:210-969-7400
Practice Address - Fax:210-590-1054
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215239164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse