Provider Demographics
NPI:1407426901
Name:WINNICKI, ANNA EWA (PA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:EWA
Last Name:WINNICKI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 STATE HIGHWAY 121
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2905
Mailing Address - Country:US
Mailing Address - Phone:469-800-5681
Mailing Address - Fax:469-800-5685
Practice Address - Street 1:6800 STATE HIGHWAY 121
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2905
Practice Address - Country:US
Practice Address - Phone:469-800-5681
Practice Address - Fax:469-800-5685
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPATEMP207Q00000X
TXPA14684363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine