Provider Demographics
NPI:1821345018
Name:MELLINGER, WINIFRED S O (APRN, MSN, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:WINIFRED
Middle Name:S O
Last Name:MELLINGER
Suffix:
Gender:F
Credentials:APRN, MSN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-5023
Mailing Address - Country:US
Mailing Address - Phone:302-544-1564
Mailing Address - Fax:
Practice Address - Street 1:122 SILVER LAKE ROAD
Practice Address - Street 2:MIDDLETOWN SCHOOL BASED HEALTH CENTER
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709
Practice Address - Country:US
Practice Address - Phone:302-378-5775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELJ0000108363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics