Provider Demographics
NPI:1265161079
Name:FUNK, LUCIA VIRGINIA (RN)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:VIRGINIA
Last Name:FUNK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8051 MOUNT OURAY RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80125-9058
Mailing Address - Country:US
Mailing Address - Phone:210-273-6361
Mailing Address - Fax:
Practice Address - Street 1:6162 S WILLOW DR STE 100
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-5113
Practice Address - Country:US
Practice Address - Phone:303-795-4584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1680928163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse