=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336633577
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGELIA DAWN LOMU FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2018
-----------------------------------------------------
Last Update Date | 12/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1683 MAIN ST
-----------------------------------------------------
City | WINDSOR
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80550-7921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-400-7618
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 830 W 57TH ST
-----------------------------------------------------
City | CASPER
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82601-6420
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-674-9194
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 1759.1759
-----------------------------------------------------
License Number State | WY
-----------------------------------------------------