Provider Demographics
NPI:1316474158
Name:WINSOR, KIARA (FNP-BC)
Entity type:Individual
Prefix:
First Name:KIARA
Middle Name:
Last Name:WINSOR
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KIARA
Other - Middle Name:
Other - Last Name:THORNTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2005 PISGAH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-3309
Mailing Address - Country:US
Mailing Address - Phone:336-716-9150
Mailing Address - Fax:
Practice Address - Street 1:2005 PISGAH CHURCH RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-3309
Practice Address - Country:US
Practice Address - Phone:336-716-9150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704303022363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704303022OtherSTATE PROFESSIONAL LICENSE