Healthcare Provider Details

I. General information

NPI: 1487797577
Provider Name (Legal Business Name): DEBORAH J LANTZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 E 20TH AVE KAISER-PERMANENTE DEPARTMENT OF NEUROLOGY
DENVER CO
80205-5423
US

IV. Provider business mailing address

1375 E. 20TH AVENUE KAISER-PERMANENTE-DEPARTMENT OF NEUROLOGY
DENVER CO
80205-5202
US

V. Phone/Fax

Practice location:
  • Phone: 303-861-3639
  • Fax:
Mailing address:
  • Phone: 303-861-3639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number59857
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: