Provider Demographics
NPI:1598808222
Name:WINKELMAN, PENCHITT (FNP)
Entity Type:Individual
Prefix:MRS
First Name:PENCHITT
Middle Name:
Last Name:WINKELMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10990 SUNNYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-3338
Mailing Address - Country:US
Mailing Address - Phone:909-797-1697
Mailing Address - Fax:
Practice Address - Street 1:10990 SUNNYSIDE DR
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-3338
Practice Address - Country:US
Practice Address - Phone:909-797-1697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA187765363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily