Healthcare Provider Details

I. General information

NPI: 1962442947
Provider Name (Legal Business Name): LANA J SIMON F.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LANA J BUCK F.N.P.

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4567 E 9TH AVE
DENVER CO
80220-3908
US

IV. Provider business mailing address

4567 E 9TH AVE
DENVER CO
80220-3908
US

V. Phone/Fax

Practice location:
  • Phone: 303-320-2121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0006018-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: