Provider Demographics
NPI:1558453878
Name:WINN, KAMA D (FNP)
Entity Type:Individual
Prefix:
First Name:KAMA
Middle Name:D
Last Name:WINN
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:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:MONAHANS
Mailing Address - State:TX
Mailing Address - Zip Code:79756-0040
Mailing Address - Country:US
Mailing Address - Phone:432-943-2511
Mailing Address - Fax:432-943-6833
Practice Address - Street 1:406 S GARY AVE
Practice Address - Street 2:
Practice Address - City:MONAHANS
Practice Address - State:TX
Practice Address - Zip Code:79756-4799
Practice Address - Country:US
Practice Address - Phone:432-943-2511
Practice Address - Fax:432-943-6833
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX548844363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1588672448Medicaid
TX162649105Medicaid
TX1881782423Medicaid
TX1881782423Medicaid