Provider Demographics
NPI:1962458729
Name:LANE, ANITA KRAUS (MD, FACP)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:KRAUS
Last Name:LANE
Suffix:
Gender:F
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ELM AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3120
Mailing Address - Country:US
Mailing Address - Phone:719-576-7006
Mailing Address - Fax:719-576-7981
Practice Address - Street 1:6 ELM AVE STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3120
Practice Address - Country:US
Practice Address - Phone:719-576-7006
Practice Address - Fax:719-576-7981
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33575207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01335751Medicaid
CO01335751Medicaid
COJ50017Medicare ID - Type Unspecified