Provider Demographics
NPI:1386279271
Name:WINNEBERGER, ASHLEY (RN, CARN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:WINNEBERGER
Suffix:
Gender:F
Credentials:RN, CARN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01904-2323
Mailing Address - Country:US
Mailing Address - Phone:781-346-7532
Mailing Address - Fax:
Practice Address - Street 1:280 UNION ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1353
Practice Address - Country:US
Practice Address - Phone:781-691-7176
Practice Address - Fax:781-586-0280
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2304334163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management