Provider Demographics
NPI:1902001985
Name:GEIER, LANA (NP)
Entity Type:Individual
Prefix:MRS
First Name:LANA
Middle Name:
Last Name:GEIER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SHOSHONE
Mailing Address - Street 2:
Mailing Address - City:TRINIDAD
Mailing Address - State:CO
Mailing Address - Zip Code:81082
Mailing Address - Country:US
Mailing Address - Phone:719-251-0277
Mailing Address - Fax:
Practice Address - Street 1:400 BENEDICTA AVE STE A
Practice Address - Street 2:
Practice Address - City:TRINIDAD
Practice Address - State:CO
Practice Address - Zip Code:81082-2089
Practice Address - Country:US
Practice Address - Phone:719-846-2206
Practice Address - Fax:719-846-8355
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO65631363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07656317Medicaid