Provider Demographics
NPI:1972060580
Name:WINKEL, KRISTINA KELSCH (RN)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:KELSCH
Last Name:WINKEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 W 200 N
Mailing Address - Street 2:
Mailing Address - City:MANTI
Mailing Address - State:UT
Mailing Address - Zip Code:84642-1246
Mailing Address - Country:US
Mailing Address - Phone:435-835-2231
Mailing Address - Fax:435-835-2233
Practice Address - Street 1:40 W 200 N
Practice Address - Street 2:
Practice Address - City:MANTI
Practice Address - State:UT
Practice Address - Zip Code:84642-1246
Practice Address - Country:US
Practice Address - Phone:435-835-2231
Practice Address - Fax:435-835-2233
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7350321-3102163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT87-0629869Medicaid