Provider Demographics
NPI:1851194294
Name:WINNETT, MIKAELA NYKOLE (LPN)
Entity type:Individual
Prefix:MRS
First Name:MIKAELA
Middle Name:NYKOLE
Last Name:WINNETT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2733 WESTON AVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14305-3229
Mailing Address - Country:US
Mailing Address - Phone:716-861-2192
Mailing Address - Fax:
Practice Address - Street 1:2733 WESTON AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14305-3229
Practice Address - Country:US
Practice Address - Phone:716-861-2192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY323866164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse