MEDICARE: JESSIE RAE WINKLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	241782	MT

General Provider Information

NPI Number	:	1245058791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSIE RAE WINKLER

Provider Business Mailing Address
First Line	:	37 HAWK DR
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-6426
Country	:	US
Telephone Number	:	406-868-8344
Fax Number	:

Provider Business Practice Location Address
First Line	:	2012 14TH ST SW STE 2
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-3412
Country	:	US
Telephone Number	:	406-758-7490
Fax Number	:	406-758-7080

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2024
Last Update Date	:	10/17/2024

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Directions to “ JESSIE RAE WINKLER ” Practice Location

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