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NPI Code Detail

MEDICARE: HEATHER WINTERS

MEDICARE:   HEATHER  WINTERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1126800000XDental AssistantA14427

General Provider Information

NPI Number : 1104383611
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER WINTERS
Provider Business Mailing Address
First Line : 6980 FAIRVIEW RD
Second Line :
City : BAXTER
State : MN
Zip : 56425-7836
Country : US
Telephone Number : 218-454-7000
Fax Number :
Provider Business Practice Location Address
First Line : 6980 FAIRVIEW RD
Second Line :
City : BAXTER
State : MN
Zip : 56425-7836
Country : US
Telephone Number : 218-454-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2019
Last Update Date : 02/21/2019

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Directions to “ HEATHER WINTERS ” Practice Location

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