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Individual
MARY WINKELS
Active
Individual
MARY WINKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHA,CDE
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
R1728
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27Y011467NH01
ANTHEM PROVIDER
NH
01
—
R1728
STATE LICENSE
NH
Enumeration date
03/22/2007
Last updated
01/22/2008
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