Provider Demographics
NPI:1740090299
Name:WINJUM, LANA (DC)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:WINJUM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 COZY CV
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:FL
Mailing Address - Zip Code:32439-2963
Mailing Address - Country:US
Mailing Address - Phone:850-797-4811
Mailing Address - Fax:
Practice Address - Street 1:1255 OLD JOLLY BAY RD UNIT B101
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:FL
Practice Address - Zip Code:32439-4356
Practice Address - Country:US
Practice Address - Phone:850-880-6046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH15304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor