Healthcare Provider Details

I. General information

NPI: 1831023332
Provider Name (Legal Business Name): BART WINTERS APRN-CNS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

561 WALDRON ST
TRAVIS AFB CA
94535-2163
US

IV. Provider business mailing address

1225 BLACK OAK CT
VACAVILLE CA
95687-7603
US

V. Phone/Fax

Practice location:
  • Phone: 707-424-4816
  • Fax:
Mailing address:
  • Phone: 700-424-4816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.343454
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAPRN.CNS.0019504
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: