Provider Demographics
NPI:1285765651
Name:WINGE, MARLYS JULIA (NP)
Entity type:Individual
Prefix:
First Name:MARLYS
Middle Name:JULIA
Last Name:WINGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 HANNAHS RST
Mailing Address - Street 2:
Mailing Address - City:FREDERIKSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00840-3668
Mailing Address - Country:US
Mailing Address - Phone:340-244-5869
Mailing Address - Fax:340-718-1092
Practice Address - Street 1:4043 ESTATE LA GRANDE PRINCESSE
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-0000
Practice Address - Country:US
Practice Address - Phone:340-718-1092
Practice Address - Fax:340-718-1090
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI10579 P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily