Healthcare Provider Details

I. General information

NPI: 1750048385
Provider Name (Legal Business Name): ELSIE MAE WINKEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 DUNCAN DR
SAVANNAH GA
31409-5107
US

IV. Provider business mailing address

1061 HARMON AVE
FORT STEWART GA
31314-5641
US

V. Phone/Fax

Practice location:
  • Phone: 912-315-3016
  • Fax: 912-315-2414
Mailing address:
  • Phone: 912-315-3016
  • Fax: 912-315-2414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number68211
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: