Healthcare Provider Details

I. General information

NPI: 1427041532
Provider Name (Legal Business Name): NANCY WINEBARGER P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 MONTICELLO RD
WEAVERVILLE NC
28787-9441
US

IV. Provider business mailing address

63 MONTICELLO RD
WEAVERVILLE NC
28787-9441
US

V. Phone/Fax

Practice location:
  • Phone: 828-645-3066
  • Fax: 828-658-1445
Mailing address:
  • Phone: 828-645-3066
  • Fax: 828-658-1445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number102598
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: