Provider Demographics
NPI:1104006436
Name:WINTORY, SHERYL
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:WINTORY
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 1:5358 W ARID CANYON DR
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85658-4153
Mailing Address - Country:US
Mailing Address - Phone:520-744-4408
Mailing Address - Fax:
Practice Address - Street 1:5358 W ARID CANYON DR
Practice Address - Street 2:
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85658-4153
Practice Address - Country:US
Practice Address - Phone:520-744-4408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-03
Last Update Date:2007-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209000378363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner