Provider Demographics
NPI:1215075825
Name:WINTER, CHERYL ANN (FNP)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:WINTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17937 I-45 S STE 115
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8783
Mailing Address - Country:US
Mailing Address - Phone:832-237-3500
Mailing Address - Fax:888-237-7954
Practice Address - Street 1:13171 MISTY WILLOW DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5635
Practice Address - Country:US
Practice Address - Phone:832-237-3500
Practice Address - Fax:832-237-0200
Is Sole Proprietor?:No
Enumeration Date:2007-02-03
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX624976363LF0000X, 163WD0400X
TXDT02706133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20-0439248OtherCORPORATION EIN #
TX8D0663Medicare ID - Type Unspecified
TXTXB120361Medicare PIN