MEDICARE: DANA WINDSOR

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	363L00000X	Nurse Practitioner	2014001559	MO

General Provider Information

NPI Number	:	1982027157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA WINDSOR

Provider Business Mailing Address
First Line	:	13655 RIVERPORT DR
Second Line	:
City	:	MARYLAND HEIGHTS
State	:	MO
Zip	:	63043-4812
Country	:	US
Telephone Number	:	888-686-2504
Fax Number	:

Provider Business Practice Location Address
First Line	:	8870 COUNTY LANE 213
Second Line	:
City	:	WEBB CITY
State	:	MO
Zip	:	64870-7201
Country	:	US
Telephone Number	:	417-850-0567
Fax Number	:

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

Provider Enumeration Date	:	01/23/2014
Last Update Date	:	11/06/2023

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Directions to “ DANA WINDSOR ” Practice Location

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