Healthcare Provider Details

I. General information

NPI: 1376159707
Provider Name (Legal Business Name): EMMA JANE WINKLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMMA JANE ROHRER PA-C

II. Dates (important events)

Enumeration Date: 09/21/2020
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 BRAMHALL ST
PORTLAND ME
04102-3134
US

IV. Provider business mailing address

104 BLUE SPRUCE FARM RD
WESTBROOK ME
04092-3930
US

V. Phone/Fax

Practice location:
  • Phone: 207-662-4618
  • Fax:
Mailing address:
  • Phone: 207-752-6009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2461
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: