Provider Demographics
NPI:1174920631
Name:GINSBURG, LANCE (APN, AGACNP, FNP)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:GINSBURG
Suffix:
Gender:M
Credentials:APN, AGACNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1263 LAKE PLAZA DR STE 120
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3510
Mailing Address - Country:US
Mailing Address - Phone:719-776-3330
Mailing Address - Fax:719-776-3349
Practice Address - Street 1:1263 LAKE PLAZA DR STE 120
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3510
Practice Address - Country:US
Practice Address - Phone:719-776-3330
Practice Address - Fax:719-776-3349
Is Sole Proprietor?:No
Enumeration Date:2014-11-28
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN1618208163W00000X
COAPN0991545-NP363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily