Provider Demographics
NPI:1376278564
Name:LUE WINSTON, LA DONNA L (APRN,ACAGNP, MSN ED)
Entity Type:Individual
Prefix:MRS
First Name:LA DONNA
Middle Name:L
Last Name:LUE WINSTON
Suffix:
Gender:F
Credentials:APRN,ACAGNP, MSN ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5908 SIENA LN
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3856
Mailing Address - Country:US
Mailing Address - Phone:754-610-1000
Mailing Address - Fax:
Practice Address - Street 1:5908 SIENA LN
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3856
Practice Address - Country:US
Practice Address - Phone:954-600-0366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020918363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner