Provider Demographics
NPI:1588052823
Name:WINFUNKE-ROCHIN, ETHEL OLUYEMISI (FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:ETHEL
Middle Name:OLUYEMISI
Last Name:WINFUNKE-ROCHIN
Suffix:
Gender:F
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:ETHEL
Other - Middle Name:OLUYEMISI
Other - Last Name:WINFUNKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24871 S ELLSWORTH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-1575
Mailing Address - Country:US
Mailing Address - Phone:480-593-3563
Mailing Address - Fax:
Practice Address - Street 1:3271 E QUEEN CREEK RD STE 100
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-8508
Practice Address - Country:US
Practice Address - Phone:480-593-3563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP7488363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily