# NICOLE YVETTE WINBUSH

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1902991458
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 312299 | NC | Yes |
| 207Q00000X | Family Medicine Physician | 48415 | MN | — |
| 207Q00000X | Family Medicine Physician | 88691 | GA | — |
| 207Q00000X | Family Medicine Physician | A78596 | CA | — |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 03/17/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01-23535 | MEDICA - PRIMARY | MN |
| 01 | — | 1042337 | PREFERRED ONE | MN |
| 01 | — | 2436123 | ARAZ | MN |
| 05 | — | 43828800 | — | WI |
| 05 | — | 663943700 | — | MN |
| 01 | — | 761T6WI | BCBS | MN |
| 01 | — | A78596 | STATE MEDICAL LICENSE | CA |
| 01 | — | HP61533 | HEALTHPARTNERS | MN |