Provider Demographics
NPI:1447244223
Name:GWINNUP, ANN KATHRYN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:KATHRYN
Last Name:GWINNUP
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:127 E REDSTONE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-5356
Mailing Address - Country:US
Mailing Address - Phone:850-423-0061
Mailing Address - Fax:850-423-9954
Practice Address - Street 1:127 E REDSTONE AVE STE C
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-5356
Practice Address - Country:US
Practice Address - Phone:850-423-0061
Practice Address - Fax:850-423-9954
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2020-09-08
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Provider Licenses
StateLicense IDTaxonomies
FLME96507207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH48400Medicare UPIN