Kaisa J Winckler, HBCE,CNMT – Health Educator

Key facts

NPI: 1770927832
Entity type: Individual (NPI type 1)
Primary specialty: Health Educator 174H00000X
License: 3030-08 (NH)
Practice address: 228 Terrace Dr SW
Willmar, MN 56201-5228
Phone: (320) 979-3617
NPI assigned: Apr 19, 2013
Sex: Female
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
3030-08	NH	MD	Health Educator
022145	SD	MD	Nuclear Medicine Technology Radiologic Technologist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Health Educator	174H00000X	3030-08	NH	Yes
Nuclear Medicine Technology Radiologic Technologist	2471N0900X	022145	SD

Addresses

Primary practice location

228 Terrace Dr SW
Willmar, MN 56201-5228

Mailing address

228 Terrace Dr SW
Willmar, MN 56201-5228
Phone (320) 979-3617

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 19, 2013.

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1770927832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 TERRACE DR SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562015228",
            "telephone_number": "320-979-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 TERRACE DR SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562015228",
            "telephone_number": "320-979-3617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINCKLER",
        "first_name": "KAISA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "HBCE,CNMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NH",
            "license": "3030-08",
            "primary": true
        },
        {
            "code": "2471N0900X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Nuclear Medicine Technology",
            "state": "SD",
            "license": "022145",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

All providers in Willmar, MN · Health Educator in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.