Basic Information
| Provider Information | |||||||||
| NPI: | 1750918900 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WINIKOR | ||||||||
| FirstName: | CHELSEA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 826 OLD AIRPORT RD APT 617 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296070918 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 SAINT FRANCIS DR | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296013955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642551000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2020 | ||||||||
| LastUpdateDate: | 04/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 239079 | SC | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.