Healthcare Provider Details
I. General information
NPI: 1619288446
Provider Name (Legal Business Name): LORNA GAIL DAWSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/26/2010
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2620 E PROSPECT RD STE 190
FORT COLLINS CO
80525-9098
US
IV. Provider business mailing address
2620 E PROSPECT RD STE 190
FORT COLLINS CO
80525-9098
US
V. Phone/Fax
- Phone: 970-221-1106
- Fax: 970-232-1050
- Phone: 970-657-3835
- Fax: 307-306-0307
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 27240.1075 |
| License Number State | WY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SP0808X |
| Taxonomy | Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | 27240.1075 |
| License Number State | WY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: