Kynette Windham

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704368248 Issued in MI

Practice address

20806 Eastlawn St
Apt#79
Saint Clair Shores, MI 48080-1608

Phone

(313) 241-1462

NPI assigned

Aug 8, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1346659869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20806 EASTLAWN ST",
            "address_2": "APT#79",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801608",
            "telephone_number": "313-241-1462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20806 EASTLAWN ST",
            "address_2": "APT#79",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801608",
            "telephone_number": "313-241-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDHAM",
        "first_name": "KYNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-08",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703113538",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704368248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrice Williams, COTA/L
• Braniyla Willis
• Jeanette Elizabeth Wilson, M.D.
• Stephen Wilson, MD
• Kala Winckler, M.A. CCC-SLP
• Chelsea Winstrand
• Elizabeth Ann Winterholler, M.A, L.L.P.
• Deanna Renee Wirick, MPT
• Wisam Martini, MD, PLLC
• Kamelia Leandra Wise, PT

• Registered Nurse in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.