MEDICARE: PROF. LANA BRUMFIELD NP

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	363LA2100X	Acute Care Nurse Practitioner	0991502	CO

General Provider Information

NPI Number	:	1639576929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. LANA BRUMFIELD NP

Provider Business Mailing Address
First Line	:	229 QUINCY ST
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81004-2022
Country	:	US
Telephone Number	:	719-250-1617
Fax Number	:

Provider Business Practice Location Address
First Line	:	685 CITADEL DR E STE 505
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-5372
Country	:	US
Telephone Number	:	719-265-4412
Fax Number	:	719-888-1739

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

Provider Enumeration Date	:	12/02/2014
Last Update Date	:	06/13/2024

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