Provider Demographics
NPI:1487947297
Name:WINNETT, AMBER A (PHARM D)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:A
Last Name:WINNETT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318-2035
Mailing Address - Country:US
Mailing Address - Phone:208-678-3286
Mailing Address - Fax:208-678-1679
Practice Address - Street 1:937 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-2035
Practice Address - Country:US
Practice Address - Phone:208-678-3286
Practice Address - Fax:208-678-1679
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP5444183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist