Healthcare Provider Details

I. General information

NPI: 1740431402
Provider Name (Legal Business Name): LAURA LOUISE KOBILAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA LOUISE SCOTT

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16420 W US HIGHWAY 24
WOODLAND PARK CO
80863-8760
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-1292
  • Fax:
Mailing address:
  • Phone: 970-624-2403
  • Fax: 970-490-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0005536-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: