Provider Demographics
NPI:1063585594
Name:PRATT, LAURA WINSTEAD (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:WINSTEAD
Last Name:PRATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 SENDERO DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-7154
Mailing Address - Country:US
Mailing Address - Phone:406-257-2278
Mailing Address - Fax:
Practice Address - Street 1:MONTANA CENTER, 245 WINDWARD WAY
Practice Address - Street 2:STE101
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3133
Practice Address - Country:US
Practice Address - Phone:406-756-8488
Practice Address - Fax:406-257-4663
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18072207Q00000X
MT11220207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C80708Medicare UPIN