Provider Demographics
NPI:1730229824
Name:WINSON, KIM BRIGITTE (CPNP)
Entity type:Individual
Prefix:MS
First Name:KIM
Middle Name:BRIGITTE
Last Name:WINSON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MS
Other - First Name:KIM
Other - Middle Name:THI-THIEN
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4650 BROAD RIVER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-4016
Mailing Address - Country:US
Mailing Address - Phone:803-896-9460
Mailing Address - Fax:
Practice Address - Street 1:4650 BROAD RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-4016
Practice Address - Country:US
Practice Address - Phone:803-896-9460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC197336363LP0200X, 363L00000X
SC26187363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner