Individual
PENNY WINSTEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1523 HIGHWAY 13 N, BRANDON, MS 39042-7480
(601) 421-4300
Mailing address
1523 HIGHWAY 13 N, BRANDON, MS 39042-7480
(601) 421-4300
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
801051049
DRIVERS LICENSE
MS
Enumeration date
09/18/2020
Last updated
09/18/2020
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