Provider Demographics
NPI:1467737528
Name:WINTON, RONALD DALE JR (FNP-C)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:DALE
Last Name:WINTON
Suffix:JR
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:585 INTERSTATE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-3190
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:847 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MONTEAGLE
Practice Address - State:TN
Practice Address - Zip Code:37356-7028
Practice Address - Country:US
Practice Address - Phone:931-924-7000
Practice Address - Fax:931-728-2726
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNF0911464363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care