Provider Demographics
NPI:1942439773
Name:VANWINKLE-PRESTON, LAURA ELISABETH (DNP, FNP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ELISABETH
Last Name:VANWINKLE-PRESTON
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7208
Mailing Address - Country:US
Mailing Address - Phone:214-645-2870
Mailing Address - Fax:972-715-9976
Practice Address - Street 1:5939 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-6533
Practice Address - Country:US
Practice Address - Phone:214-645-2870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP117991363LF0000X, 363L00000X
TXF0609164363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX209905301Medicaid
TX8276NNOtherBCBS
TXP01446869OtherRR
TX209905303Medicaid
TX329103YMR3Medicare PIN
TXP00769776Medicare PIN
TX8L19282Medicare PIN