Provider Demographics
NPI:1861178816
Name:HARRIS-WATKINS, JOHNETTA M
Entity type:Individual
Prefix:
First Name:JOHNETTA
Middle Name:M
Last Name:HARRIS-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 1:187 S. IRVINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80018-4629
Mailing Address - Country:US
Mailing Address - Phone:720-982-0725
Mailing Address - Fax:720-328-0092
Practice Address - Street 1:187 S. IRVINGTON STREET
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80018-4629
Practice Address - Country:US
Practice Address - Phone:720-982-0725
Practice Address - Fax:720-328-0092
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker