Provider Demographics
NPI:1467700823
Name:WINSOR, MICHELLE JOHNSON (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:JOHNSON
Last Name:WINSOR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 VESTAL PKWY E FL 2
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1947
Mailing Address - Country:US
Mailing Address - Phone:607-306-7546
Mailing Address - Fax:607-821-7848
Practice Address - Street 1:2220 VESTAL PKWY E FL 2
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1947
Practice Address - Country:US
Practice Address - Phone:607-306-7546
Practice Address - Fax:607-821-7848
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337524-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily