LILLIAN FUNKHOUSER


Address: 90 Health Park Dr Ste 160, Louisville, CO 80027-9742
Phone: 3036739030

LILLIAN FUNKHOUSER (NPI# 1174014948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174014948
Entity Type Individual
Full Name LILLIAN FUNKHOUSER
Credential FNP-C
Practice Address 90 Health Park Dr Ste 160
Louisville
CO 80027-9742
Practice Telephone 3036739030
Mailing Telephone 3036739030
Enumeration Date 2018-05-28
Last Update Date 2018-12-19
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
APN.0994312-NP CO Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CO RN LICENSE RN.1653383 01
CO NURSE PRACTITIONER - APN APN.0994312-NP 01

Office Location

Street Address 90 HEALTH PARK DR STE 160
City LOUISVILLE
State CO
Zip Code 80027-9742

Providers in the same location

NPI Name Taxonomy Address Enumeration
1275738510 Cornerstone Pediatrics Associates Pediatrics 90 Health Park Dr Ste 160, Louisville, CO 80027-9742 2007-06-18
1619582616 Erica Ashley Persichetti Nurse Practitioner 90 Health Park Dr Ste 160, Louisville, CO 80027-9742 2020-09-15

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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Competitor

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City LOUISVILLE
Zip Code 80027

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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