Provider Demographics
NPI:1073557187
Name:WINTER, CHRISTY M (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:M
Last Name:WINTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 S. MAPLE ST.
Mailing Address - Street 2:P.O. BOX 309
Mailing Address - City:GARNETT
Mailing Address - State:KS
Mailing Address - Zip Code:66032-0309
Mailing Address - Country:US
Mailing Address - Phone:785-448-3131
Mailing Address - Fax:785-271-2220
Practice Address - Street 1:536 W 4TH AVE.
Practice Address - Street 2:
Practice Address - City:GARNETT
Practice Address - State:KS
Practice Address - Zip Code:66032-1355
Practice Address - Country:US
Practice Address - Phone:785-448-2674
Practice Address - Fax:785-448-3091
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-01102363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q77449Medicare UPIN
KS110918029Medicare PIN
KSKA2500020Medicare PIN