Provider Demographics
NPI:1366164154
Name:WINKLE, EMILY JOAN (APRN-CNP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JOAN
Last Name:WINKLE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:NUTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-6255
Mailing Address - Fax:614-293-4156
Practice Address - Street 1:395 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1267
Practice Address - Country:US
Practice Address - Phone:614-293-6255
Practice Address - Fax:614-293-4156
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0005751Medicaid