MEDICARE: COLLEEN J LAKIN ANP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	71001960A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	677700	OTHER	IN	GROUP MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457497984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN J LAKIN ANP

Provider Business Mailing Address
First Line	:	1000 E MAIN ST
Second Line	:	ATTN MED STAFF OFFICE
City	:	DANVILLE
State	:	IN
Zip	:	46122-1948
Country	:	US
Telephone Number	:	317-837-5566
Fax Number	:	317-718-6793

Provider Business Practice Location Address
First Line	:	1080 N GREEN ST STE 150
Second Line	:
City	:	BROWNSBURG
State	:	IN
Zip	:	46112-2419
Country	:	US
Telephone Number	:	317-386-5618
Fax Number	:	317-386-5463

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	03/11/2026

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