Provider Demographics
NPI:1407816572
Name:WINKLER, JULIE D (PA)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:D
Last Name:WINKLER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16 N LA PLATA CT
Mailing Address - Street 2:PO BOX 2188
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-4283
Mailing Address - Country:US
Mailing Address - Phone:301-392-3330
Mailing Address - Fax:301-392-3950
Practice Address - Street 1:16 N LA PLATA CT
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4283
Practice Address - Country:US
Practice Address - Phone:301-392-3330
Practice Address - Fax:301-392-3950
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002471363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD165148ZAQBMedicare PIN
MDP47562Medicare UPIN