Provider Demographics
NPI:1780693457
Name:WINKELS, ANNITA M (MPT)
Entity type:Individual
Prefix:
First Name:ANNITA
Middle Name:M
Last Name:WINKELS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:ANNITA
Other - Middle Name:M
Other - Last Name:HOEPPNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3125 E SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55812-2356
Mailing Address - Country:US
Mailing Address - Phone:218-390-8788
Mailing Address - Fax:
Practice Address - Street 1:2711 W SUPERIOR ST
Practice Address - Street 2:SUITE 209
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55806-1810
Practice Address - Country:US
Practice Address - Phone:218-390-8788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10363225100000X
MN6659225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI64-05191OtherMEDICA-POPLAR
WI64-05192OtherMEDICA-ASHLAND
WI124G7HOOtherGROUP HEALTH/BCBS OF MN
WI40448000Medicaid
WIP00206707OtherRAILROAD MEDICARE