Provider Demographics
NPI:1366680001
Name:WINTERS, ANGELA ANNETTE (CST/CFA)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:ANNETTE
Last Name:WINTERS
Suffix:
Gender:F
Credentials:CST/CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3055
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-3055
Mailing Address - Country:US
Mailing Address - Phone:505-898-5106
Mailing Address - Fax:
Practice Address - Street 1:4301 CANADA PL NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5638
Practice Address - Country:US
Practice Address - Phone:505-400-1469
Practice Address - Fax:505-792-9401
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM103386246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant