Provider Demographics
NPI:1194842278
Name:WINLAND, KACI ANNETTE (LPN)
Entity Type:Individual
Prefix:
First Name:KACI
Middle Name:ANNETTE
Last Name:WINLAND
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 MAIN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43724-1354
Mailing Address - Country:US
Mailing Address - Phone:740-732-1091
Mailing Address - Fax:
Practice Address - Street 1:527 MAIN ST APT 2
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:OH
Practice Address - Zip Code:43724-1354
Practice Address - Country:US
Practice Address - Phone:740-732-1091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN125302164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse