Provider Demographics
NPI:1215292495
Name:WINFIELD, MARY (RN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:WINFIELD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ALLEN
Mailing Address - State:LA
Mailing Address - Zip Code:70767-2144
Mailing Address - Country:US
Mailing Address - Phone:225-342-7525
Mailing Address - Fax:225-383-3552
Practice Address - Street 1:685 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767-2144
Practice Address - Country:US
Practice Address - Phone:225-342-7525
Practice Address - Fax:225-383-3552
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA093836163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health