Healthcare Provider Details

I. General information

NPI: 1225255714
Provider Name (Legal Business Name): KAREN ANNE WINTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 WESTFIELD AVE
ELIZABETH NJ
07208-1325
US

IV. Provider business mailing address

101 ORANGE AVE
CRANFORD NJ
07016-2218
US

V. Phone/Fax

Practice location:
  • Phone: 908-352-8375
  • Fax:
Mailing address:
  • Phone: 908-497-9337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number26NR11038400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: