MEDICARE: MRS. GAYLE A WINDHORST LPN NURSE

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	164W00000X	Licensed Practical Nurse	PN035803	OH

General Provider Information

NPI Number	:	1588798151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GAYLE A WINDHORST LPN NURSE

Provider Business Mailing Address
First Line	:	22636 BRIGHTLAND DR
Second Line	:
City	:	LAWRENCEBURG
State	:	IN
Zip	:	47025-9640
Country	:	US
Telephone Number	:	812-637-5233
Fax Number	:	812-637-9026

Provider Business Practice Location Address
First Line	:	6223 MARCUS CT
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-1884
Country	:	US
Telephone Number	:	513-779-6844
Fax Number	:

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	07/08/2007

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