Provider Demographics
NPI:1205520590
Name:WINSTON, KATHY MARIE (LPN)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:MARIE
Last Name:WINSTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-1713
Mailing Address - Country:US
Mailing Address - Phone:330-608-4464
Mailing Address - Fax:
Practice Address - Street 1:87 CONSERVATORY DR
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-4291
Practice Address - Country:US
Practice Address - Phone:234-334-0303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH111366164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse