Provider Demographics
NPI:1417052655
Name:WINKLER, ELIZABETH C (APRN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:WINKLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 CROMWELL AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1800
Mailing Address - Country:US
Mailing Address - Phone:860-529-7501
Mailing Address - Fax:860-527-8616
Practice Address - Street 1:546 CROMWELL AVE
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1800
Practice Address - Country:US
Practice Address - Phone:860-529-7501
Practice Address - Fax:860-527-8616
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001275363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004263795Medicaid
CT400001275CT01OtherANTHEM
CT004263795Medicaid