Healthcare Provider Details
I. General information
NPI: 1861340101
Provider Name (Legal Business Name): WINBORN MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2026
Last Update Date: 03/21/2026
Certification Date: 03/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9938 AIRLINE HWY
BATON ROUGE LA
70816-8100
US
IV. Provider business mailing address
24236 SNOWY EGRET CV
SPRINGFIELD LA
70462-8095
US
V. Phone/Fax
- Phone: 225-936-5829
- Fax: 985-781-4319
- Phone: 225-936-5829
- Fax: 985-781-4319
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
COLBY
WINBORN
Title or Position: FNP
Credential: FNP
Phone: 225-936-5829