Healthcare Provider Details

I. General information

NPI: 1821101973
Provider Name (Legal Business Name): LAURI LOHSE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 ESTRELLA AVE
LOVELAND CO
80538-3522
US

IV. Provider business mailing address

4803 BOARDWALK DR STE 120
FORT COLLINS CO
80525-3798
US

V. Phone/Fax

Practice location:
  • Phone: 970-310-3406
  • Fax:
Mailing address:
  • Phone: 709-310-3406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberAPN.0993903-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0993903
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0993903-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: