Provider Demographics
NPI:1689620874
Name:WINTERROWD, DONNA YVONNE
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:YVONNE
Last Name:WINTERROWD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3539
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-0539
Mailing Address - Country:US
Mailing Address - Phone:219-934-4200
Mailing Address - Fax:219-934-6240
Practice Address - Street 1:10010 DONALD POWERS DR
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321
Practice Address - Country:US
Practice Address - Phone:219-934-4200
Practice Address - Fax:219-934-6240
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001950A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP71685Medicare UPIN
IN707050NNMedicare ID - Type UnspecifiedMEDICARE