Basic Information
| Provider Information | |||||||||
| NPI: | 1477721066 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WINFREE | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | KAIN | ||||||||
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| Credential: | N.P.-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 N HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371303837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153964694 | ||||||||
| FaxNumber: | 6153966751 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 N HIGHLAND AVE. | ||||||||
| Address2: | |||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371303837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153964694 | ||||||||
| FaxNumber: | 6153966751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2008 | ||||||||
| LastUpdateDate: | 02/15/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APN0000012076 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | APN0000012076 | 01 | LICENSE NUMBER | OTHER |