Provider Demographics
NPI:1326424276
Name:WINNINGHAM, MARCI (APRN-CNS, MS, CCNS)
Entity Type:Individual
Prefix:MS
First Name:MARCI
Middle Name:
Last Name:WINNINGHAM
Suffix:
Gender:F
Credentials:APRN-CNS, MS, CCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 S WESTERN AVE
Mailing Address - Street 2:ATTN 200-3100
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3413
Mailing Address - Country:US
Mailing Address - Phone:405-644-6185
Mailing Address - Fax:405-713-4681
Practice Address - Street 1:4401 S WESTERN AVE
Practice Address - Street 2:ATTN 200-3100
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3413
Practice Address - Country:US
Practice Address - Phone:405-644-6185
Practice Address - Fax:405-713-4681
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK60255282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital