MEDICARE: SCOTT J WINTERS FNP

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
1	163WE0003X	Emergency Registered Nurse	F333963	NY

General Provider Information

NPI Number	:	1467653501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT J WINTERS FNP

Provider Business Mailing Address
First Line	:	1562 MARINE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3414
Country	:	US
Telephone Number	:	347-733-9938
Fax Number	:

Provider Business Practice Location Address
First Line	:	UNITED STATES ARMY
Second Line	:	WALSON ARMY HOSPITAL
City	:	FT DIX
State	:	NJ
Zip	:	08640
Country	:	US
Telephone Number	:	609-563-3963
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	07/08/2007

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