Individual
LARA KATHLEEN WIGINTON-MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1025 PENNOCK PL, FORT COLLINS, CO 80524-3257
(970) 495-8800
(970) 495-8820
Mailing address
1025 PENNOCK PL, FORT COLLINS, CO 80524-3257
(970) 495-8800
(970) 495-8820
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
190225
CO
363L00000X
Nurse Practitioner
990222
CO
367A00000X
Advanced Practice Midwife
Primary
APN.0006038-CNM
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40925722
—
CO
Enumeration date
10/08/2008
Last updated
03/22/2016
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