Provider Demographics
NPI:1437589397
Name:WINGERTER, PATRICIA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:WINGERTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2703 MAJESTIC CT
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302-6690
Mailing Address - Country:US
Mailing Address - Phone:570-994-1214
Mailing Address - Fax:570-687-9533
Practice Address - Street 1:805 SEVEN BRIDGE RD # 201
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-7943
Practice Address - Country:US
Practice Address - Phone:570-994-1214
Practice Address - Fax:570-687-9533
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2015-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA21603601374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide