Healthcare Provider Details

I. General information

NPI: 1912838152
Provider Name (Legal Business Name): PRESTON LIENEMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ROCKY MOUNTAIN AVE
LOVELAND CO
80538-9004
US

IV. Provider business mailing address

2121 E HARMONY RD UNIT 100
FORT COLLINS CO
80528-3401
US

V. Phone/Fax

Practice location:
  • Phone: 970-744-9556
  • Fax:
Mailing address:
  • Phone: 970-221-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPN.1001520-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: