Provider Demographics
NPI:1063793495
Name:WINTERS, LAURA RUTH (MNS, RD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:RUTH
Last Name:WINTERS
Suffix:
Gender:F
Credentials:MNS, RD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:RUTH
Other - Last Name:TREBLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:760 GOLF VIEW DRIVE, SUITE # 200
Mailing Address - Street 2:RENAL CARE CONSULTANTS P.C.
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504
Mailing Address - Country:US
Mailing Address - Phone:541-618-4400
Mailing Address - Fax:541-842-9491
Practice Address - Street 1:760 GOLF VIEW DRIVE, SUITE # 200
Practice Address - Street 2:RENAL CARE CONSULTANTS PC
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504
Practice Address - Country:US
Practice Address - Phone:541-618-4400
Practice Address - Fax:541-842-9491
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR944133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
724178OtherAMERICAN DIETETIC ASSN.