Provider Demographics
NPI:1215466750
Name:DAGOSTINO, LORI (NP)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:DAGOSTINO
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7951 E MAPLEWOOD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4726
Mailing Address - Country:US
Mailing Address - Phone:303-930-7800
Mailing Address - Fax:303-930-7860
Practice Address - Street 1:2312 N NEVADA AVE STE 400
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-5320
Practice Address - Country:US
Practice Address - Phone:719-577-2555
Practice Address - Fax:719-577-2553
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993211-NP363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner