Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | MD34168 | DC |
NPI | 1023106408 |
---|---|
Provider Name | Glenna B. Winnie |
First Address | Fairfax, VA 22031 |
Second Address | Purcellville, VA 20132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 06/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
034817300 | (05) | DC |
0885 | CAREFIRST (01) | DC |
565500501 | (05) | DC |
6739989 | (05) | VA |
D77495 | (02) |