Provider Demographics
NPI:1023792579
Name:WINKERT, KATHLEEN MARIE (PA)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MARIE
Last Name:WINKERT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3742 WINTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-9230
Mailing Address - Country:US
Mailing Address - Phone:804-330-3335
Mailing Address - Fax:804-320-2717
Practice Address - Street 1:3742 WINTERFIELD RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-9230
Practice Address - Country:US
Practice Address - Phone:804-330-3335
Practice Address - Fax:804-320-2717
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical