MR. LANNY DOUGLAS APRN NPI 1427159664

NPI Information

NPI: 1427159664
Provider Name: MR. LANNY DOUGLAS, APRN
Classification: Clinical Nurse Specialist - 364SP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
400 EAST HORSETOOTH RD
SUITE 307
FORT COLLINS, CO
ZIP 80525
Phone: (970) 556-4502
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MR. Lanny Douglas, APRN is a psychiatric/mental health clinical nurse specialist in Fort Collins, CO with 31 years of experience. MR. Lanny Douglas, APRN NPI is 1427159664. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduation Year:1993

The provider's business location address is:

400 EAST HORSETOOTH RD
SUITE 307
FORT COLLINS, CO
ZIP 80525
Phone: (970) 556-4502
Fax: (970) 493-5131

The NPI 1427159664 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/26/2006 and was last updated on 8/21/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	364SP0807X	Clinical Nurse Specialist	Psychiatric/Mental Health, Child & Adolescent	18756.196	WYOMING	No
2	364SP0808X	Clinical Nurse Specialist	Psychiatric/Mental Health	180365-5256	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	S54469	MEDICARE UPIN	WYOMING
2	W308674	MEDICARE ID-TYPE UNSPECIFIED	WYOMING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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