Provider Demographics
NPI:1174711618
Name:WINSKI, BRENDA (NP)
Entity type:Individual
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First Name:BRENDA
Middle Name:
Last Name:WINSKI
Suffix:
Gender:F
Credentials:NP
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Other - Middle Name:
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Mailing Address - Street 1:3434 47TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1817
Mailing Address - Country:US
Mailing Address - Phone:303-444-8100
Mailing Address - Fax:303-444-8113
Practice Address - Street 1:1225 E COOLSPRING AVE
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-6312
Practice Address - Country:US
Practice Address - Phone:219-878-5029
Practice Address - Fax:219-878-8493
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2023-07-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN71002517A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200889520Medicaid
IN217230UUUUMedicare PIN