Shannon Watkins, PA-C
Physician Assistant, Surgical in Phoenix, AZ. Individual provider (NPI-1).
NPI number1013491968
StatusActive
Last updated in NPPESAug 22, 2023
Details
- NPI
- 1013491968
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Shannon Watkins
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 17, 2018
- Certification date
- Aug 9, 2023
- Last updated
- Aug 22, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | 7230 | AZ | Yes |
Other names
- Shannon Leipus (Former Name)
Practice location
370 E Virginia Ave Ste 100Phoenix, AZ 85004-1254
Phone 602-258-4788
Mailing address
20808 N 27th Ave Apt 2030Phoenix, AZ 85027-3235
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