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General NPI Number Information
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NPI Number | 1730229824
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Entity Type | Individual
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Provider Name | KIM BRIGITTE WINSON CPNP
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 4650 BROAD RIVER RD
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City | COLUMBIA
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State | SC
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Zip | 29210-4016
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Country | US
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Telephone | 803-896-9460
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Fax |
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Provider Business Mailing Address
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Address Line | 4650 BROAD RIVER RD
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City | COLUMBIA
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State | SC
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Zip | 29210-4016
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Country | US
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Telephone | 803-896-9460
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 197336
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 26187
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 197336
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License Number State | NC
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