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 1:4567 E 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4567 E 9TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3908
Practice Address - Country:US
Practice Address - Phone:303-320-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0006018-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1762068OtherAMERICA'S PPO
MN0122006OtherMEDICA
WI43988300Medicaid
MNHP37855OtherHEALTHPARTNERS
MN292P3BUOtherBLUE CROSS
IA0599738Medicaid
MN680105600Medicaid
CO99084503Medicaid
CO025933OtherKAISER COMMERCIAL NUMBER
MN1032875OtherPREFERRED ONE
MN291P3BUOtherBLUE CROSS
MN292P3BUOtherBLUE CROSS
MN1762068OtherAMERICA'S PPO
MN500004778Medicare PIN