Provider Demographics
NPI:1487621488
Name:WINN, MARIA P (FNP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:P
Last Name:WINN
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:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-5908
Mailing Address - Fax:757-625-0466
Practice Address - Street 1:855 W BRAMBLETON AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1005
Practice Address - Country:US
Practice Address - Phone:757-446-5908
Practice Address - Fax:757-625-0466
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001143448363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA500017575Medicare PIN
VAS72509Medicare UPIN
VA500000705Medicare PIN
VA27893NOtherSENTARA OPTIMA
VAS72509Medicare UPIN
NC04062OtherNC BC/BS
NC7004062Medicaid
VAPAROtherMUTIPLAN
VAPAROtherUSA MANAGED CARE
VAPAROtherCORVEL/CORCARE
VA007788126Medicaid
VA500000705Medicare PIN