Provider Demographics
NPI:1386437168
Name:WINFREY, DESHEAL (RN)
Entity type:Individual
Prefix:MS
First Name:DESHEAL
Middle Name:
Last Name:WINFREY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 DOLOSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7659
Mailing Address - Country:US
Mailing Address - Phone:870-225-8579
Mailing Address - Fax:
Practice Address - Street 1:2907 DOLOSTONE WAY
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-7659
Practice Address - Country:US
Practice Address - Phone:870-225-8579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN258920163WC0400X, 163WH0200X, 163WH1000X, 163WC0200X, 163WI0500X, 163WM0705X, 163WR0400X, 163WW0000X, 163WP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health