Healthcare Provider Details

I. General information

NPI: 1770409831
Provider Name (Legal Business Name): LAURIANNE ASHLY THOMPSON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 271038
FORT COLLINS CO
80527-1038
US

IV. Provider business mailing address

PO BOX 271038
FORT COLLINS CO
80527-1038
US

V. Phone/Fax

Practice location:
  • Phone: 970-582-3955
  • Fax:
Mailing address:
  • Phone: 970-582-3955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1002103-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: