Suzan Joy Watkinson, CCLS
Individual provider Active NPI Specialist · Clifton, VA
NPI 1104553965 · NPPES record last updated Aug 2, 2022
Key facts
- NPI
- 1104553965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 1123571
- Practice address
- 6233 Sandstone Way
Clifton, VA 20124-2440 - Phone
- (703) 577-6848
- NPI assigned
- Aug 2, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1123571 | Yes |
Addresses
Primary practice location
6233 Sandstone Way
Clifton, VA 20124-2440
Mailing address
6233 Sandstone Way
Clifton, VA 20124-2440
Phone (703) 577-6848
Other providers in Clifton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.