Provider Demographics
NPI:1093358004
Name:WINTERS, MONIKA HILDEGARD
Entity Type:Individual
Prefix:MRS
First Name:MONIKA
Middle Name:HILDEGARD
Last Name:WINTERS
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 1:4150 LAKE PLEASANT RD S
Mailing Address - Street 2:
Mailing Address - City:OSSEO
Mailing Address - State:MI
Mailing Address - Zip Code:49266-9623
Mailing Address - Country:US
Mailing Address - Phone:517-200-8013
Mailing Address - Fax:
Practice Address - Street 1:4150 LAKE PLEASANT RD S
Practice Address - Street 2:
Practice Address - City:OSSEO
Practice Address - State:MI
Practice Address - Zip Code:49266-9623
Practice Address - Country:US
Practice Address - Phone:517-200-8013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider