MEDICARE: JEAN P WINFIELD APN

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	363L00000X	Nurse Practitioner	9494502	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609861467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN P WINFIELD APN

Provider Business Mailing Address
First Line	:	5804 INDIAN PINES BLVD
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-2302
Country	:	US
Telephone Number	:	772-828-3752
Fax Number	:

Provider Business Practice Location Address
First Line	:	5804 INDIAN PINES BLVD
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-2302
Country	:	US
Telephone Number	:	772-828-3752
Fax Number	:

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

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	01/27/2023

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