1427834423 NPI number — MRS. BRITANY CHERIE WINSTON NP

Table of content: MRS. BRITANY CHERIE WINSTON NP (NPI 1427834423)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427834423 NPI number — MRS. BRITANY CHERIE WINSTON NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WINSTON
Provider First Name:
BRITANY
Provider Middle Name:
CHERIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427834423
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4028 LAKE MANOR WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30349-8221
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-484-5192
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5470 MERIDIAN MARK RD BLDG E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30342-1624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
731-394-1145
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/05/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  RN305140 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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