Provider Demographics
NPI:1780186023
Name:VANWINKLE, DURLEEN
Entity Type:Individual
Prefix:
First Name:DURLEEN
Middle Name:
Last Name:VANWINKLE
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 1:3407 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-1713
Mailing Address - Country:US
Mailing Address - Phone:940-733-7473
Mailing Address - Fax:940-733-7473
Practice Address - Street 1:3407 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-1713
Practice Address - Country:US
Practice Address - Phone:940-733-7473
Practice Address - Fax:940-733-7473
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider