Provider Demographics
NPI:1821716424
Name:WINTERS, LAUREN KATHRYN
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:KATHRYN
Last Name:WINTERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:BUSSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACAGNP
Mailing Address - Street 1:9318 ECKERT RD
Mailing Address - Street 2:
Mailing Address - City:IOWA COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:77583-4406
Mailing Address - Country:US
Mailing Address - Phone:936-499-7201
Mailing Address - Fax:
Practice Address - Street 1:9318 ECKERT RD
Practice Address - Street 2:
Practice Address - City:IOWA COLONY
Practice Address - State:TX
Practice Address - Zip Code:77583-4406
Practice Address - Country:US
Practice Address - Phone:936-499-7201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1057554363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care