Doctor Name: | MRS. CLAUDEENA WATT AUSTIN |
NPI Number: | 1013052950 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | $$$$$$$$$ |
Business Practice Address: | 122 Valley View Cir Bloomington, IL - 617049371 |
Business Phone Number: | 3098291907 |
Business Fax Number: | 3098291904 |
Mailing Address: | 122 Valley View Cir, BLOOMINGTON |
State: | IL |
Postal Code: | 617049371 |
Phone Number: | 3098291907 |
Fax Number: | 3098291904 |
NPI Enumeration Date: | 02/20/2007 |
NPI Last Update Date: | 07/26/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | $$$$$$$$$ |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |