Provider Demographics
NPI:1821101973
Name:LOHSE, LAURI (APN)
Entity Type:Individual
Prefix:
First Name:LAURI
Middle Name:
Last Name:LOHSE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4803 BOARDWALK DR STE 120
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3798
Mailing Address - Country:US
Mailing Address - Phone:709-310-3406
Mailing Address - Fax:
Practice Address - Street 1:4803 BOARDWALK DR STE 120
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3798
Practice Address - Country:US
Practice Address - Phone:970-310-3406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO09939032084P0800X
COAPN.0993903-NP163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAPN.0993903-NPOtherNURSE PRACTITIONER LICENSE
FL1848792OtherLICENSE