Provider Demographics
NPI:1619402344
Name:WINFIELD, MARY ELIZABETH (RD)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:WINFIELD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 MANOR DR
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-4917
Mailing Address - Country:US
Mailing Address - Phone:814-472-6060
Mailing Address - Fax:814-472-1293
Practice Address - Street 1:429 MANOR DR
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-4917
Practice Address - Country:US
Practice Address - Phone:814-472-6060
Practice Address - Fax:814-472-1293
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA816009133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered