Provider Demographics
NPI:1184670390
Name:WINSHIP, MARY C (CNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:WINSHIP
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-6976
Mailing Address - Fax:216-635-6428
Practice Address - Street 1:33355 HEALTH CAMPUS BLVD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-1399
Practice Address - Country:US
Practice Address - Phone:440-937-9099
Practice Address - Fax:440-937-9755
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN131921163WR0400X
OH05993363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00706002OtherRRCARE
OH2284308Medicaid
OH2284308Medicaid
P55239Medicare UPIN
OHP00706002OtherRRCARE