Provider Demographics
NPI:1245409515
Name:DINWIDDIE, ANNETTE PATRICE
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:PATRICE
Last Name:DINWIDDIE
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 1:10608 CROWLEY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-2427
Mailing Address - Country:US
Mailing Address - Phone:314-521-4644
Mailing Address - Fax:314-521-4644
Practice Address - Street 1:10608 CROWLEY DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-2427
Practice Address - Country:US
Practice Address - Phone:314-521-4644
Practice Address - Fax:314-521-4644
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide