Individual
NICOLE MARIE WINNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN, WHNP-BC
Contact information
Practice address
1901 N TUSTIN AVE, SANTA ANA, CA 92705-7817
(657) 859-5463
(909) 495-1300
Mailing address
1901 N TUSTIN AVE, SANTA ANA, CA 92705-7817
(657) 859-5463
(909) 495-1300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
790048
CA
363L00000X
Nurse Practitioner
95027089
CA
363LW0102X
Women's Health Nurse Practitioner
Primary
95027089
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
790048
REGISTERED NURSE LICENSE NUMBER
CA
01
—
95027089
NURSE PRACTITIONER FURNISHING LICENSE
CA
Enumeration date
12/21/2023
Last updated
12/21/2023
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