Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | LL38142 | SC |
Y | 2080N0001X | Neonatal-Perinatal Doctor | E-13198 | AR |
NPI | 1043690985 |
---|---|
Provider Name | Victoria Lynnette Winningham |
First Address | Mayflower, AR 72106-9000 |
Second Address | Greenville, SC 29605-4210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2015 |
Last Update Date | 27/07/2021 |