Provider Demographics
NPI:1518107721
Name:WINSTANLEY, MOIRA F (APN)
Entity Type:Individual
Prefix:MS
First Name:MOIRA
Middle Name:F
Last Name:WINSTANLEY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MISS
Other - First Name:MOIRA
Other - Middle Name:
Other - Last Name:FITZGERALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1025 WALNUT ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5001
Mailing Address - Country:US
Mailing Address - Phone:215-955-6523
Mailing Address - Fax:215-923-9519
Practice Address - Street 1:1025 WALNUT ST
Practice Address - Street 2:SUITE 700
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5001
Practice Address - Country:US
Practice Address - Phone:215-955-6523
Practice Address - Fax:215-923-9519
Is Sole Proprietor?:No
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP003187J363L00000X
PARN313813L363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner