Provider Demographics
NPI:1316591522
Name:WINEMILLER, GERALD (APRN)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:WINEMILLER
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MONAHANS
Mailing Address - State:TX
Mailing Address - Zip Code:79756-4015
Mailing Address - Country:US
Mailing Address - Phone:432-943-2068
Mailing Address - Fax:432-943-3114
Practice Address - Street 1:813 E 4TH ST
Practice Address - Street 2:
Practice Address - City:MONAHANS
Practice Address - State:TX
Practice Address - Zip Code:79756-4015
Practice Address - Country:US
Practice Address - Phone:432-943-2068
Practice Address - Fax:432-943-3114
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11016842363LF0000X
TX1099450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty