Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 191766 | NC |
Y | 2080N0001X | Neonatal-Perinatal Doctor | ME140387 | FL |
NPI | 1114362787 |
---|---|
Provider Name | Dr. Kathryn Anne Winn |
First Address | Orlando, FL 32806-2031 |
Second Address | Orlando, FL 32806-2009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2013 |
Last Update Date | 21/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AC5385578-R072 | DEA (01) | NC |