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General NPI Number Information
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NPI Number | 1043538283
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Entity Type | Individual
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Provider Name | MARY E LAUTENBACH NP
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Gender | Female
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Dates
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Enumeration Date | 05/12/2010
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Last Update Date | 05/12/2010
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Provider Practice Location Address
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Address Line | 9777 S YOSEMITE ST SUITE 200
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City | LONETREE
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State | CO
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Zip | 80124-3191
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Country | US
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Telephone | 303-803-1000
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Fax | 720-475-8484
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Provider Business Mailing Address
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Address Line | 9777 S YOSEMITE ST SUITE 200
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City | LONETREE
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State | CO
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Zip | 80124-3191
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Country | US
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Telephone | 303-803-1000
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Fax | 720-475-8484
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP5695
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License Number State | CO
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