Provider Demographics
NPI:1417089418
Name:WINN, DANNY E (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:E
Last Name:WINN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 BEAMAN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-2602
Mailing Address - Country:US
Mailing Address - Phone:910-596-5633
Mailing Address - Fax:910-596-0977
Practice Address - Street 1:520 BEAMAN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2602
Practice Address - Country:US
Practice Address - Phone:910-596-5633
Practice Address - Fax:910-596-0977
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001001989363AS0400X
IN10000352A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P05702Medicare UPIN