Provider Demographics
NPI:1295408482
Name:WINKLEMAN, KORTNEY (ARNP)
Entity Type:Individual
Prefix:
First Name:KORTNEY
Middle Name:
Last Name:WINKLEMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 SR 20 W
Mailing Address - Street 2:SUITE 300
Mailing Address - City:INTERLACHEN
Mailing Address - State:FL
Mailing Address - Zip Code:32148
Mailing Address - Country:US
Mailing Address - Phone:386-684-0195
Mailing Address - Fax:
Practice Address - Street 1:1114 SR 20 W
Practice Address - Street 2:SUITE 300
Practice Address - City:INTERLACHEN
Practice Address - State:FL
Practice Address - Zip Code:32148
Practice Address - Country:US
Practice Address - Phone:386-684-0195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014487363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner