Provider Demographics
NPI:1487390324
Name:BROWN-ELLINGTON, WINSOME LORAIN (APRN)
Entity type:Individual
Prefix:
First Name:WINSOME
Middle Name:LORAIN
Last Name:BROWN-ELLINGTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:WINSOME
Other - Middle Name:LORAIN
Other - Last Name:BROWN-ELLINGTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:20422 BERRYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3475
Mailing Address - Country:US
Mailing Address - Phone:813-420-6437
Mailing Address - Fax:
Practice Address - Street 1:20422 BERRYWOOD LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3475
Practice Address - Country:US
Practice Address - Phone:813-420-6437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11019648363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty