Provider Demographics
NPI:1467653501
Name:WINTERS, SCOTT J (FNP)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:J
Last Name:WINTERS
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 1:1562 MARINE PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3414
Mailing Address - Country:US
Mailing Address - Phone:347-733-9938
Mailing Address - Fax:
Practice Address - Street 1:UNITED STATES ARMY
Practice Address - Street 2:WALSON ARMY HOSPITAL
Practice Address - City:FT DIX
Practice Address - State:NJ
Practice Address - Zip Code:08640
Practice Address - Country:US
Practice Address - Phone:609-563-3963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333963163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency