Provider Demographics
NPI:1558386490
Name:WINELAND, MARSHA A (CNP)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:A
Last Name:WINELAND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 CLEVELAND MASSILLON RD
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-5611
Mailing Address - Country:US
Mailing Address - Phone:330-753-6643
Mailing Address - Fax:330-753-3465
Practice Address - Street 1:3939 CLEVELAND MASSILLON RD
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-5611
Practice Address - Country:US
Practice Address - Phone:330-753-6643
Practice Address - Fax:330-753-3465
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP08719363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2661114Medicaid
OHQ64647Medicare UPIN
OHNP20323Medicare PIN