Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APN.0995681-NP | CO |
NPI | 1013534288 |
---|---|
Provider Name | Katy Lynn Fangmeier |
First Address | Fort Collins, CO 80525-2463 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2020 |
Last Update Date | 13/07/2020 |