Provider Demographics
NPI:1124236542
Name:WINTER, WENDEE K (PNP)
Entity type:Individual
Prefix:
First Name:WENDEE
Middle Name:K
Last Name:WINTER
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 BARSTOW AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-2228
Mailing Address - Country:US
Mailing Address - Phone:559-327-7976
Mailing Address - Fax:559-327-7974
Practice Address - Street 1:510 BARSTOW AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-2228
Practice Address - Country:US
Practice Address - Phone:559-327-7976
Practice Address - Fax:559-327-7974
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA542878363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics