Provider Demographics
NPI:1538606678
Name:WATKINS, ELLIOTT
Entity type:Individual
Prefix:
First Name:ELLIOTT
Middle Name:
Last Name:WATKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 7TH ST NW
Mailing Address - Street 2:APT 903
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3564
Mailing Address - Country:US
Mailing Address - Phone:202-758-2534
Mailing Address - Fax:
Practice Address - Street 1:1301 7TH ST NW
Practice Address - Street 2:APT 903
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3564
Practice Address - Country:US
Practice Address - Phone:202-758-2534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide