Organization
FAMILY MEDICINE OF WINONA P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL PETERSON (ASST CLINIC MANAGER)
(507) 454-5050
Entity
Organization
Contact information
Practice address
825 MANKATO AVE STE 210, WINONA, MN 55987-4866
(507) 454-5050
(507) 454-5102
Mailing address
825 MANKATO AVE STE 210, WINONA, MN 55987-4866
(507) 454-5050
(507) 454-5102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124645
UCARE
MN
01
—
2508
HEALTH PARTNERS
MN
01
—
2F659FA
BCBS
MN
01
—
32871300
WISC MEDICAL ASSISTANCE
MN
Enumeration date
03/07/2007
Last updated
07/21/2022
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