1659587210 NPI number — MS. MARYFRAN WINKLER CRIMONE APRN

Table of content: MS. MARYFRAN WINKLER CRIMONE APRN (NPI 1659587210)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659587210 NPI number — MS. MARYFRAN WINKLER CRIMONE APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRIMONE
Provider First Name:
MARYFRAN
Provider Middle Name:
WINKLER
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CRIMONE
Provider Other First Name:
MICKIE
Provider Other Middle Name:
WINKLER
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1659587210
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10601 WILLOWBROOK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POTOMAC
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20854-4457
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-299-7475
Provider Business Mailing Address Fax Number:
301-299-9511

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6201 EXECUTIVE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20852-3906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-299-7475
Provider Business Practice Location Address Fax Number:
301-299-9511
Provider Enumeration Date:
05/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WP0809X , with the licence number:  RO49675 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com