Provider Demographics
NPI:1669218277
Name:WINSTON, SEGRID YOLANDA (CPT)
Entity type:Individual
Prefix:MRS
First Name:SEGRID
Middle Name:YOLANDA
Last Name:WINSTON
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:MISS
Other - First Name:SEGRID
Other - Middle Name:YOLANDA
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPT
Mailing Address - Street 1:29886 PARK HILL DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35757-6106
Mailing Address - Country:US
Mailing Address - Phone:256-661-7180
Mailing Address - Fax:
Practice Address - Street 1:29886 PARK HILL DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35757-6106
Practice Address - Country:US
Practice Address - Phone:256-661-7180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171W00000X, 374700000X, 374U00000X
TNNPCN-16840-4498246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractor
No374700000XNursing Service Related ProvidersTechnician
No374U00000XNursing Service Related ProvidersHome Health Aide