Doctor Name: | MRS. MARY LEANN WINFREY |
NPI Number: | 1467604470 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 1666 |
Business Practice Address: | 3335 Highway 41a N Unionville, TN - 371805033 |
Business Phone Number: | 9312948464 |
Business Fax Number: | 9312948477 |
Mailing Address: | 291 Wheel Rd, SHELBYVILLE |
State: | TN |
Postal Code: | 371606289 |
Phone Number: | 9312942410 |
Fax Number: | |
NPI Enumeration Date: | 10/21/2008 |
NPI Last Update Date: | 10/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 1666 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |