Provider Demographics
NPI:1336105097
Name:WINTERS, JOYCE ELAINE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:ELAINE
Last Name:WINTERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:JOYCE
Other - Middle Name:ELAINE
Other - Last Name:FUNK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7720 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-1021
Mailing Address - Country:US
Mailing Address - Phone:440-220-4518
Mailing Address - Fax:
Practice Address - Street 1:6394 SLATER RD
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:OH
Practice Address - Zip Code:44003-9573
Practice Address - Country:US
Practice Address - Phone:440-293-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN040773164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse