Individual
SUSAN LAMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1025 PENNCOCK PLACE #121, FT COLLINS, CO 80528-8052
(970) 495-8800
Mailing address
4212 GOLDENEYE DR, FORT COLLINS, CO 80526-3637
(907) 360-6968
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
774
AK
363LF0000X
Family Nurse Practitioner
Primary
APN.0996558-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730113739
PFMC CLINIC NPI
—
01
—
743109721
TAX ID
—
05
—
NP99111
—
AK
Enumeration date
11/16/2006
Last updated
02/21/2022
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