MEDICARE: CAMILLE BRIDGETTE WINSTEAD AGNP

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	363LP2300X	Primary Care Nurse Practitioner	5019626	NC

General Provider Information

NPI Number	:	1639933369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILLE BRIDGETTE WINSTEAD AGNP

Provider Business Mailing Address
First Line	:	4845 JAMES TOWN DR
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27896-0039
Country	:	US
Telephone Number	:	252-714-8966
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 CABARRUS AVE
Second Line	:	SUITE 200
City	:	CONCORD
State	:	NC
Zip	:	28025
Country	:	US
Telephone Number	:	855-743-2247
Fax Number	:	855-857-7333

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

Provider Enumeration Date	:	02/13/2024
Last Update Date	:	06/07/2024

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