Provider Demographics
NPI:1518773241
Name:KOIMA, WINNIE JEPKOGEI (NP)
Entity type:Individual
Prefix:
First Name:WINNIE
Middle Name:JEPKOGEI
Last Name:KOIMA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10201 E JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-3149
Mailing Address - Country:US
Mailing Address - Phone:248-991-7235
Mailing Address - Fax:313-499-8389
Practice Address - Street 1:10201 E JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-3149
Practice Address - Country:US
Practice Address - Phone:248-991-7235
Practice Address - Fax:313-499-8389
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704380659163W00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse