MEDICARE: JAMES HARVEY WINCHESTER APRN-NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	43176	WY
2	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist	43176	WY
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	111197	NE

General Provider Information

NPI Number	:	1740583491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES HARVEY WINCHESTER APRN-NP

Provider Business Mailing Address
First Line	:	9360 PAWNEE RD STE B-1
Second Line	:
City	:	GIBBON
State	:	NE
Zip	:	68840-6114
Country	:	US
Telephone Number	:	308-627-6390
Fax Number	:	308-468-9118

Provider Business Practice Location Address
First Line	:	9360 PAWNEE RD
Second Line	:
City	:	GIBBON
State	:	NE
Zip	:	68840
Country	:	US
Telephone Number	:	308-627-6390
Fax Number	:	308-468-9118

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

Provider Enumeration Date	:	12/17/2010
Last Update Date	:	03/21/2019

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