Provider Demographics
NPI:1306686969
Name:WINGS, DENISHA
Entity type:Individual
Prefix:
First Name:DENISHA
Middle Name:
Last Name:WINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 FLORISSANT RD STE 1
Mailing Address - Street 2:
Mailing Address - City:NORMANDY
Mailing Address - State:MO
Mailing Address - Zip Code:63121-2526
Mailing Address - Country:US
Mailing Address - Phone:314-488-5240
Mailing Address - Fax:
Practice Address - Street 1:1274 GOLDEN POND CT
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-2054
Practice Address - Country:US
Practice Address - Phone:314-405-8070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)