Provider Demographics
NPI:1992272108
Name:THAYER, LAUREN (FNP-BC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:THAYER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 W 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-5057
Mailing Address - Country:US
Mailing Address - Phone:303-940-9118
Mailing Address - Fax:
Practice Address - Street 1:6301 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-5057
Practice Address - Country:US
Practice Address - Phone:303-940-9118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.021780363LF0000X
IL209021780363LF0000X
COAPN.0094244-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0103604OtherRXN LICENSE
CO0994244-NPOtherAPRN LICENSE
CO1658250OtherRN LICENSE
CO1658250OtherRN LICENSE