Healthcare Provider Details

I. General information

NPI: 1700873254
Provider Name (Legal Business Name): LAURIE HARRIS DUNN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 N 17TH AVE
GREELEY CO
80631-9117
US

IV. Provider business mailing address

2211 SHOOTING STAR LN
FT COLLINS CO
80521-1362
US

V. Phone/Fax

Practice location:
  • Phone: 970-304-6420
  • Fax:
Mailing address:
  • Phone: 970-304-6420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number63538
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: