Provider Demographics
NPI:1558751651
Name:WINBORN, COLBY (FNP-C)
Entity Type:Individual
Prefix:
First Name:COLBY
Middle Name:
Last Name:WINBORN
Suffix:
Gender:M
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 1:37830 NAN WESLEY RD
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70706-0434
Mailing Address - Country:US
Mailing Address - Phone:225-936-5829
Mailing Address - Fax:
Practice Address - Street 1:24236 SNOWY EGRET CV
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:LA
Practice Address - Zip Code:70462-8095
Practice Address - Country:US
Practice Address - Phone:225-936-5829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-27
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08188363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily