Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APN.0010074-NP | CO |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 1096 | AK |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APN.0010074-NP | CO |
N | 363LF0000X | Nurse Practitioner - Family Medicine | NP 10074 | CO |
NPI | 1003047325 |
---|---|
Provider Name | Lane D Looka |
First Address | Holyoke, CO 80734-1854 |
Second Address | Holyoke, CO 80734-1854 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2009 |
Last Update Date | 04/01/2021 |