Provider Demographics
NPI:1821789140
Name:WINN, SHEILA
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:WINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 E ASH ST
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-3806
Mailing Address - Country:US
Mailing Address - Phone:919-429-6078
Mailing Address - Fax:919-429-6077
Practice Address - Street 1:906 E ASH ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-3806
Practice Address - Country:US
Practice Address - Phone:919-394-8591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2023-07-05
Deactivation Date:2023-06-20
Deactivation Code:
Reactivation Date:2023-07-05
Provider Licenses
StateLicense IDTaxonomies
NC374700000X, 374U00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No374700000XNursing Service Related ProvidersTechnicianGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty