Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APN.0994008-NP | CO |
NPI | 1003208661 |
---|---|
Provider Name | Brittany Lain |
First Address | Brighton, CO 80601-2252 |
Second Address | Greeley, CO 80631-9117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2015 |
Last Update Date | 11/08/2020 |