Provider Demographics
NPI:1699987396
Name:WINTERS, MALINDA (CFNP)
Entity type:Individual
Prefix:
First Name:MALINDA
Middle Name:
Last Name:WINTERS
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26150 BRIARDALE AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-2310
Mailing Address - Country:US
Mailing Address - Phone:330-274-2272
Mailing Address - Fax:330-732-2484
Practice Address - Street 1:9772 DIAGONAL RD
Practice Address - Street 2:
Practice Address - City:MANTUA
Practice Address - State:OH
Practice Address - Zip Code:44255-9128
Practice Address - Country:US
Practice Address - Phone:330-274-2272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08672363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily