Provider Demographics
NPI:1447583521
Name:WINTERMEYER, ALAN (FNP)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:WINTERMEYER
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 MENDOCINO AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-4332
Mailing Address - Country:US
Mailing Address - Phone:707-524-1599
Mailing Address - Fax:707-524-1858
Practice Address - Street 1:1501 MENDOCINO AVE.
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401
Practice Address - Country:US
Practice Address - Phone:707-524-1599
Practice Address - Fax:707-524-1858
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA283764363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily