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NPI Code Detail

MEDICARE: KEYSHA D. AHMAD-WINBORNE FNP-BC

MEDICARE: KEYSHA D. AHMAD-WINBORNE FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0024174351VA

General Provider Information

NPI Number : 1326583345
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEYSHA D. AHMAD-WINBORNE FNP-BC
Provider Business Mailing Address
First Line : 946 N MAIN ST
Second Line :
City : CHASE CITY
State : VA
Zip : 23924-1139
Country : US
Telephone Number : 434-372-5141
Fax Number : 434-372-8910
Provider Business Practice Location Address
First Line : 946 N MAIN ST
Second Line :
City : CHASE CITY
State : VA
Zip : 23924-1139
Country : US
Telephone Number : 434-372-5141
Fax Number : 434-372-8910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2016
Last Update Date : 12/29/2016

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Directions to “ KEYSHA D. AHMAD-WINBORNE FNP-BC” Practice Location

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