Provider Demographics
NPI:1396994356
Name:WINNINGHAM, DONNA J (APN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:WINNINGHAM
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 N WHITNEY AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2480
Mailing Address - Country:US
Mailing Address - Phone:931-528-2557
Mailing Address - Fax:931-526-2559
Practice Address - Street 1:438 N WHITNEY AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2480
Practice Address - Country:US
Practice Address - Phone:931-528-2557
Practice Address - Fax:931-526-2559
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN13619364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health