Provider Demographics
NPI:1902194186
Name:WINTER, MELANIE A (CRNP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:A
Last Name:WINTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:ANN
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE STE 661
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3437
Mailing Address - Country:US
Mailing Address - Phone:610-649-8085
Mailing Address - Fax:
Practice Address - Street 1:100 E LANCASTER AVE STE 661
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3437
Practice Address - Country:US
Practice Address - Phone:610-649-8085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011156363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1747143OtherMLHC B/S AA #
PA232359401OtherMLHC TIN
PA440771OtherMLHC MEDICARE AA #