Provider Demographics
NPI:1700039021
Name:LAUER, PAMELA ELAINE (FNP-BC, WCC, CRRN)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ELAINE
Last Name:LAUER
Suffix:
Gender:F
Credentials:FNP-BC, WCC, CRRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 S CLARKSON ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2811
Mailing Address - Country:US
Mailing Address - Phone:303-789-8317
Mailing Address - Fax:
Practice Address - Street 1:3425 S CLARKSON ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2811
Practice Address - Country:US
Practice Address - Phone:303-789-8317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5856363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO30837871Medicaid