Healthcare Provider Details

I. General information

NPI: 1659068559
Provider Name (Legal Business Name): KATHERINE LYNN WININGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 E WALNUT ST
WASHINGTON IN
47501-2860
US

IV. Provider business mailing address

3947 S 600 E
MONTGOMERY IN
47558-5579
US

V. Phone/Fax

Practice location:
  • Phone: 812-254-2760
  • Fax:
Mailing address:
  • Phone: 812-257-1425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number28179232A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: