Provider Demographics
NPI:1508643420
Name:AYISI WINNER, EUGENIA NANA
Entity type:Individual
Prefix:
First Name:EUGENIA
Middle Name:NANA
Last Name:AYISI WINNER
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 1:1500 N CONGRESS AVE APT A63
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-1713
Mailing Address - Country:US
Mailing Address - Phone:561-631-7935
Mailing Address - Fax:
Practice Address - Street 1:INTER AMERICAN UNIVERSITY
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00614-4050
Practice Address - Country:US
Practice Address - Phone:787-878-5475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11032195367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered