Provider Demographics
NPI:1528184462
Name:WINKELS, MARY (PHA,CDE)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:WINKELS
Suffix:
Gender:F
Credentials:PHA,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 DANIEL WEBSTER HWY
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-5224
Mailing Address - Country:US
Mailing Address - Phone:603-891-4400
Mailing Address - Fax:
Practice Address - Street 1:173 DANIEL WEBSTER HWY
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-5224
Practice Address - Country:US
Practice Address - Phone:603-891-4400
Practice Address - Fax:603-891-4414
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR1728183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHR1728OtherSTATE LICENSE
NH27Y011467NH01OtherANTHEM PROVIDER