Provider Demographics
NPI:1457891095
Name:WININGEAR, DEANNA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:
Last Name:WININGEAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 EAGLES PERCH CT
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-2952
Mailing Address - Country:US
Mailing Address - Phone:636-697-2327
Mailing Address - Fax:
Practice Address - Street 1:635 S STURGEON ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY CITY
Practice Address - State:MO
Practice Address - Zip Code:63361-2707
Practice Address - Country:US
Practice Address - Phone:573-564-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000175319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist