Healthcare Provider Details

I. General information

NPI: 1205039567
Provider Name (Legal Business Name): CHAD C WINCHESTER ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 11/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S COULTER ST
AMARILLO TX
79106-1786
US

IV. Provider business mailing address

1400 WALLACE BLVD
AMARILLO TX
79106-1708
US

V. Phone/Fax

Practice location:
  • Phone: 806-414-9650
  • Fax: 806-354-5730
Mailing address:
  • Phone: 806-414-9650
  • Fax: 806-354-5730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number677765
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number677765
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP117348
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP117348
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: