Provider Demographics
NPI:1376115592
Name:WINFREY, ADRIENNA ERIN
Entity Type:Individual
Prefix:
First Name:ADRIENNA
Middle Name:ERIN
Last Name:WINFREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADRIENNA
Other - Middle Name:
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 741632
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70174-1632
Mailing Address - Country:US
Mailing Address - Phone:504-339-9330
Mailing Address - Fax:
Practice Address - Street 1:1205 SAINT CHARLES AVE APT 812
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-8412
Practice Address - Country:US
Practice Address - Phone:504-339-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable