Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 607265 | TX |
NPI | 1003018896 |
---|---|
Provider Name | Mary Beth Winton |
First Address | Stephenville, TX 76401-2074 |
Second Address | Weatherford, TX 76086-5705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 08/07/2007 |