Individual
MRS. LAUREAN JADA WINSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
321 REGENCY PARK STE 100, O FALLON, IL 62269-1887
(618) 416-7970
Mailing address
321 REGENCY PARK STE 100, O FALLON, IL 62269-1887
(618) 416-7970
(618) 416-7971
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004813
IL
363A00000X
Physician Assistant
11502
MN
363A00000X
Physician Assistant
55629
CA
363A00000X
Physician Assistant
PA11166
TX
Other
Enumeration date
09/25/2013
Last updated
02/18/2021
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