Provider Demographics
NPI:1467877340
Name:WINFORD, TAESHA CYBILLE NICOLE (FNP)
Entity type:Individual
Prefix:
First Name:TAESHA
Middle Name:CYBILLE NICOLE
Last Name:WINFORD
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 1:408 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:BERRYVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72616-4320
Mailing Address - Country:US
Mailing Address - Phone:870-423-2320
Mailing Address - Fax:870-423-7431
Practice Address - Street 1:408 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:BERRYVILLE
Practice Address - State:AR
Practice Address - Zip Code:72616-4320
Practice Address - Country:US
Practice Address - Phone:870-423-2320
Practice Address - Fax:870-423-7431
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014003272363LP2300X
ARA004246363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care