MEDICARE: STARZ WINT

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
1	163W00000X	Registered Nurse	4704434256	MI

General Provider Information

NPI Number	:	1558224816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STARZ WINT

Provider Business Mailing Address
First Line	:	1332 ANDERSON RD
Second Line	:
City	:	CLAWSON
State	:	MI
Zip	:	48017-1044
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1332 ANDERSON RD
Second Line	:
City	:	CLAWSON
State	:	MI
Zip	:	48017-1044
Country	:	US
Telephone Number	:	586-231-1423
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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Directions to “ STARZ WINT ” Practice Location

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