Provider Demographics
NPI:1962442947
Name:SIMON, LANA J (FNP)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:J
Last Name:SIMON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LANA
Other - Middle Name:J
Other - Last Name:BUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2045 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5437
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO189339363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO025933OtherKAISER COMMERCIAL NUMBER
MN292P3BUOtherBLUE CROSS
WI43988300Medicaid
MNHP37855OtherHEALTHPARTNERS
IA0599738Medicaid
MN1032875OtherPREFERRED ONE
MN291P3BUOtherBLUE CROSS
CO99084503Medicaid
MN1762068OtherAMERICA'S PPO
MN680105600Medicaid
MN0122006OtherMEDICA
MN292P3BUOtherBLUE CROSS
MN1762068OtherAMERICA'S PPO
MN500004778Medicare PIN