Individual
KELLY WINTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1900 CENTRA CARE CIRCLE, CENTRA CARE CLINIC WOMENS CHILDRENS, ST CLOUD, MN 56303
(320) 654-3630
Mailing address
1900 CENTRA CARE CIRCLE, CENTRA CARE CLINIC WOMENS CHILDRENS, ST CLOUD, MN 56303
(320) 654-3630
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R128866-9
MN
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
R1288669
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-04519
MEDICA
—
01
—
1045420
PREFERRED ONE
—
01
—
135486
UCARE
—
01
—
2384629
AMERICA'S PPO (ARAZ)
—
01
—
434G5WI
BCBS MN
MN
01
—
HP56438
HEALTH PARTNERS
—
Enumeration date
01/27/2006
Last updated
08/21/2007
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