Provider Demographics
NPI:1205593662
Name:WINZENREID, DARLA
Entity type:Individual
Prefix:MRS
First Name:DARLA
Middle Name:
Last Name:WINZENREID
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 1:120 OLD CADIZ RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:OH
Mailing Address - Zip Code:43977-9519
Mailing Address - Country:US
Mailing Address - Phone:740-296-3393
Mailing Address - Fax:
Practice Address - Street 1:68353 BANNOCK UNIONTOWN RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9736
Practice Address - Country:US
Practice Address - Phone:740-695-9344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker