Healthcare Provider Details

I. General information

NPI: 1003351958
Provider Name (Legal Business Name): ALICIA WINFIELD RN, MSN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2017
Last Update Date: 01/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 FOUNDATION WAY SUITE 3800
MARTINSBURG WV
25401-9003
US

IV. Provider business mailing address

2000 FOUNDATION WAY SUITE 3800
MARTINSBURG WV
25401-9003
US

V. Phone/Fax

Practice location:
  • Phone: 304-596-6839
  • Fax: 304-596-5799
Mailing address:
  • Phone: 304-596-6839
  • Fax: 304-596-5799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number023261
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: