Provider Demographics
NPI:1205260718
Name:WINN, AZSHA RENEE (FNP)
Entity type:Individual
Prefix:
First Name:AZSHA
Middle Name:RENEE
Last Name:WINN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:AZSHA
Other - Middle Name:RENEE
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 746723
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6723
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:773-866-8014
Practice Address - Street 1:13667 EUREKA RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-1332
Practice Address - Country:US
Practice Address - Phone:734-530-6777
Practice Address - Fax:734-468-1156
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY672570-1163W00000X
MI4704310223363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704310223OtherMICHIGAN NP LICENSE NUMBER
NY672570-1OtherRN LICENSE NUMBER
NY672570-1OtherRN LICENSE NUMBER