Provider Demographics
NPI:1881339802
Name:WINFUL, SAMUEL AWUAH (NP)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:AWUAH
Last Name:WINFUL
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 THORNGATE LN
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-3091
Mailing Address - Country:US
Mailing Address - Phone:770-896-5344
Mailing Address - Fax:
Practice Address - Street 1:1959 THORNGATE LN
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3091
Practice Address - Country:US
Practice Address - Phone:770-896-5344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF10210452363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily