Provider Demographics
NPI:1043403314
Name:WINELAND, AMY LYNN (RN, CPNP, ND)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNN
Last Name:WINELAND
Suffix:
Gender:F
Credentials:RN, CPNP, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:CO
Mailing Address - Zip Code:80435-8475
Mailing Address - Country:US
Mailing Address - Phone:970-668-9195
Mailing Address - Fax:970-668-4115
Practice Address - Street 1:360 PEAK ONE DR.
Practice Address - Street 2:SUITE 230
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-668-9195
Practice Address - Fax:970-668-4115
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO119749163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO94628548Medicaid