Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 1046701 | AK |
NPI | 1013277235 |
---|---|
Provider Name | Marynell Bailey Winslow |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35233-2110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2012 |
Last Update Date | 22/05/2012 |