Provider Demographics
NPI:1386036895
Name:WINT, MARVET (DNP)
Entity type:Individual
Prefix:DR
First Name:MARVET
Middle Name:
Last Name:WINT
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:114 ARABELLA PKWY
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-4246
Mailing Address - Country:US
Mailing Address - Phone:770-256-3843
Mailing Address - Fax:770-946-8871
Practice Address - Street 1:114 ARABELLA PKWY
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-4246
Practice Address - Country:US
Practice Address - Phone:770-256-3843
Practice Address - Fax:770-946-8871
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-21
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCH008421311ZA0620X
GAF03170428363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGAP235113OtherGBI ORI