Provider Demographics
NPI:1467877340
Name:WINFORD, TAESHA CYBILLE NICOLE (FNP)
Entity Type:Individual
Prefix:
First Name:TAESHA
Middle Name:CYBILLE NICOLE
Last Name:WINFORD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 HWY 65 N
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-3911
Mailing Address - Country:US
Mailing Address - Phone:870-414-5400
Mailing Address - Fax:870-414-5401
Practice Address - Street 1:1401 HWY 65 N
Practice Address - Street 2:SUITE 230
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-3911
Practice Address - Country:US
Practice Address - Phone:870-414-5400
Practice Address - Fax:870-414-5401
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014003272363LP2300X
ARA004246363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care