Provider Demographics
NPI:1073113940
Name:WINNER, CHELSEA ANN
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ANN
Last Name:WINNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 COLONEL GLENN HWY.
Mailing Address - Street 2:117 HEALTH SCIENCES BLDG.
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45435-0001
Mailing Address - Country:US
Mailing Address - Phone:937-775-3458
Mailing Address - Fax:
Practice Address - Street 1:7395 STATE ROUTE 119
Practice Address - Street 2:
Practice Address - City:MARIA STEIN
Practice Address - State:OH
Practice Address - Zip Code:45860-8717
Practice Address - Country:US
Practice Address - Phone:567-644-5184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program