Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 5101021959 | MI |
N | 207Q00000X | Family Doctor | 54245 | MN |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 5101021959 | MI |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 54245 | MN |
NPI | 1235457763 |
---|---|
Provider Name | Amber Marie Winkelman |
First Address | Bloomington, MN 55425-4516 |
Second Address | Minneapolis, MN 55407-3570 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2010 |
Last Update Date | 28/07/2020 |