Healthcare Provider Details

I. General information

NPI: 1295282085
Provider Name (Legal Business Name): MARGARET WINKELER RN, IBCLC, CEIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S LINCOLN AVE
O FALLON IL
62269-2665
US

IV. Provider business mailing address

3424 MIDDLEBURY WAY
BELLEVILLE IL
62221-3372
US

V. Phone/Fax

Practice location:
  • Phone: 618-402-9481
  • Fax:
Mailing address:
  • Phone: 252-571-9372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number195201
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: