Provider Demographics
NPI:1619081171
Name:WINZELER, SHELLEY WILCOX (PA-C)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:WILCOX
Last Name:WINZELER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:L
Other - Last Name:WILCOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1651 INDEPENDENCE CT
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4173
Mailing Address - Country:US
Mailing Address - Phone:205-580-1500
Mailing Address - Fax:
Practice Address - Street 1:1651 INDEPENDENCE CT
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-4173
Practice Address - Country:US
Practice Address - Phone:205-580-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA-429363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-31373OtherBCBS-AL
ALCM5660OtherRAILROAD MEDICARE
AL051531373Medicare ID - Type Unspecified
AL515-31373OtherBCBS-AL