Provider Demographics
NPI:1255633053
Name:WINSLETT, LAURA L (RN, CNS-BC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:L
Last Name:WINSLETT
Suffix:
Gender:F
Credentials:RN, CNS-BC
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:TAWATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1110 VANDERBILT CIR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-4788
Mailing Address - Country:US
Mailing Address - Phone:512-415-1015
Mailing Address - Fax:512-324-8212
Practice Address - Street 1:601 E 15TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1930
Practice Address - Country:US
Practice Address - Phone:512-415-1015
Practice Address - Fax:512-324-8212
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX527003364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148684703Medicaid
TX148684703Medicaid