Provider Demographics
NPI:1417784208
Name:WINT, DANNIA MARIE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:DANNIA
Middle Name:MARIE
Last Name:WINT
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 RIVER CLUB DR NE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-6615
Mailing Address - Country:US
Mailing Address - Phone:845-558-6421
Mailing Address - Fax:
Practice Address - Street 1:1303 RIVER CLUB DR NE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-6615
Practice Address - Country:US
Practice Address - Phone:845-558-6421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN304058363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily