Healthcare Provider Details

I. General information

NPI: 1588121545
Provider Name (Legal Business Name): HANNAH PROCIDA WINTERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH GIOSELYN SALTINA PROCIDA

II. Dates (important events)

Enumeration Date: 02/26/2019
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2407 REICHART RD
BLOOMSBURG PA
17815-8969
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-9800
US

V. Phone/Fax

Practice location:
  • Phone: 570-416-1816
  • Fax: 570-416-1810
Mailing address:
  • Phone: 570-416-1816
  • Fax: 570-416-1810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number315585-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS025677
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: