Provider Demographics
NPI:1942246657
Name:WINCKLER, CHRISTOPHER C (CRNA)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:C
Last Name:WINCKLER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 YORK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-4661
Mailing Address - Country:US
Mailing Address - Phone:303-957-8128
Mailing Address - Fax:
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-436-8375
Practice Address - Fax:303-436-6548
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2912367500000X
CO5014367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA430078353OtherRAILROAD MEDICARE
CARN538170328OtherCALOPTIMA
CANA0029120OtherBLUE SHIELD
CO13028561Medicaid
CARN5338170Medicaid
COCO305957Medicare PIN
P77798Medicare UPIN
CO13028561Medicaid