| Dr Nicole Winter Llc | |
|
76 Traveler Palm Ct Ponte Vedra Beach FL 32082-4655 | |
| (616) 935-5136 | |
| Not Available |
| Full Name | Dr Nicole Winter Llc |
|---|---|
| Speciality | Psychologist |
| Location | 76 Traveler Palm Ct, Ponte Vedra Beach, Florida |
| Authorized Official Name and Position | Nicole Lee Winter (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 6169355136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Nicole Winter Llc 76 Traveler Palm Ct Ponte Vedra Beach FL 32082-4655 Ph: () - | Dr Nicole Winter Llc 76 Traveler Palm Ct Ponte Vedra Beach FL 32082-4655 Ph: (616) 935-5136 |
| NPI Number | 1821818410 |
|---|---|
| Provider Enumeration Date | 10/16/2024 |
| Last Update Date | 10/16/2024 |
| Certification Date | 10/16/2024 |
| Medicare PECOS PAC ID | 0941734867 |
|---|---|
| Medicare Enrollment ID | O20241114000273 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821818410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nicole Winter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578007118 PECOS PAC ID: 5092098970 Enrollment ID: I20170220002655 |
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