PAULA C DEARHOLT-WINCKLER (NPI# 1194895888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194895888 |
| Entity Type | Individual |
| Full Name | PAULA C DEARHOLT-WINCKLER |
| Credential | RN, WHCNP |
| Practice Address |
1601 Golf Course Rd Grand Rapids MN 55744-8648 |
| Mailing Address |
30521 Harris Town Rd Grand Rapids MN 55744-4776 |
| Practice Telephone | 2189991442 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2009-02-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
R124952-7 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PREFERRED ONE PROV ID | 1016947 | 01 | |
| SIOUX VALLEY PROV ID | 29076 | 01 | |
| UCARE PROVIDER ID | 122972 | 01 | |
| HEALTH PARTNERS PROV ID | HP26447 | 01 | |
| AMERICA'S PPO PROV ID | 1068173 | 01 | |
| MN | DEA | MD1203215 | 01 |
| MN | 666420200 | 05 | |
| MEDICA PROVIDER ID | 07-00637 | 01 | |
| BCBS MN PROVIDER ID | 68G08DE | 01 |
| Street Address |
1601 GOLF COURSE RD |
| City | GRAND RAPIDS |
| State | MN |
| Zip Code | 55744-8648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326023060 | Jack Victor Carlisle | Family Medicine | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2005-12-14 |
| 1568076602 | Tyler Wesley Waller | Pharmacist | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2020-09-05 |
| 1699397042 | Tiffany Alicia Axtman | Nurse Practitioner | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2020-05-08 |
| 1710511282 | Kelly Manner | Dietitian, Registered | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2020-02-24 |
| 1285273292 | Patrick James Nelson | Physician Assistant | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-12-23 |
| 1801446943 | Natalie Jo Castle | Physician Assistant | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-09-19 |
| 1578121356 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-06-05 |
| 1487210233 | Jake Heggem | Pharmacist | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-05-17 |
| 1902379159 | Grand Itasca Clinic and Hospital | Pharmacy | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-01-09 |
| 1548768534 | Michelle Overbye | Nurse Practitioner | 1601 Golf Course Rd, Grand Rapids, MN 55744 | 2018-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
| 1821631391 | Patrice Marie Curtiss | Technician | 23792 Winckler Road, Grand Rapids, MN 55744 | 2019-10-28 |
| 1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
| 1780081877 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 | 2014-12-04 |
| 1912311333 | Doctor V LLC | Psychologist | 2002 Cromell Drive, Hope House of Itasca County, Laprairie, MN 55744 | 2014-06-13 |
| 1104244987 | Linda Reinen-thompson | Contractor | 34307 Hwy. 38, Grand Rapids, MN 55744 | 2014-03-31 |
| 1275883266 | Lana Rae Jacobson | Registered Nurse | 1401 Nw 9th Street, Grand Rapids, MN 55744 | 2012-09-17 |
| 1518252048 | David Allen Griggs | Pharmacist | 2140 S.pokegama Ave., T-0904, Target, Grand Rapids, MN 55744 | 2011-06-13 |
| 1447575063 | Kelly Ann Shermoen | Pharmacist | 18 Se 10th Street, Grand Rapids, MN 55744 | 2010-04-07 |
| Find all providers in zip 55744 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972160745 | Jennifer Deibert Keck | Nurse Practitioner | 7345 Jewelbrooke Dr Se, Grand Rapids, MI 49548-7323 | 2019-05-28 |
| 1184700379 | Valerie Ruth Lucas | Nurse Practitioner | 425 Cherry Se, Grand Rapids, MI 49305 | 2006-10-31 |
| 1457333098 | Kristie Sue Buchholz | Nurse Practitioner | 4829 E Beltline Ave Ne, Grand Rapids, MI 49525-9747 | 2005-11-18 |
| 1295089043 | Judith Willink | Nurse Practitioner | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2012-11-01 |
| 1194092957 | Laura M Defraia | Nurse Practitioner | 4069 Lake Dr Se Ste 118, Grand Rapids, MI 49546-8816 | 2011-11-22 |
| 1013294222 | Kelly Ann Conley | Nurse Practitioner | 145 Michigan St Ne, Suite 6300, Grand Rapids, MI 49503-2562 | 2011-11-16 |
| 1639404288 | Emily Susannah Parker | Nurse Practitioner | 145 Michigan St Ne, Suite 3100, Grand Rapids, MI 49503-2562 | 2009-10-14 |
| 1982866000 | Nancy Vermerris | Nurse Practitioner | 3200 Knight Way Se, Grand Rapids, MI 49546-4407 | 2008-06-30 |
| 1831303668 | Jamie Lynn Rodriguez | Nurse Practitioner | 555 Midtowne Street Ne, Suite 400, Grand Rapids, MI 49503-5731 | 2007-05-10 |
| 1609953967 | Karen Lynn Ganzevoort | Nurse Practitioner | 425 Cherry St Se, Grand Rapids, MI 49503-4601 | 2006-11-01 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 55744 |
Please comment or provide details below to improve the information on PAULA C DEARHOLT-WINCKLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.