Provider Demographics
NPI:1194269910
Name:WINN, STEPHANIE (WHNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:WINN
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 SANDHURST DR
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:IL
Mailing Address - Zip Code:60548-1390
Mailing Address - Country:US
Mailing Address - Phone:815-789-1088
Mailing Address - Fax:815-786-1314
Practice Address - Street 1:831 SANDHURST DR
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:IL
Practice Address - Zip Code:60548-1390
Practice Address - Country:US
Practice Address - Phone:815-789-1088
Practice Address - Fax:815-786-1314
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015281364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health