1336633577 NPI number — ANGELIA DAWN LOMU FNP-C

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336633577 NPI number — ANGELIA DAWN LOMU FNP-C

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

LOMU

Provider First Name:

ANGELIA

Provider Middle Name:

DAWN

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

FNP-C

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1336633577

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/23/2025

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

830 W 57TH ST

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

CASPER

Provider Business Mailing Address State Name:

WY

Provider Business Mailing Address Postal Code:

82601-6420

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

541-674-9194

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

1683 MAIN ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

WINDSOR

Provider Business Practice Location Address State Name:

CO

Provider Business Practice Location Address Postal Code:

80550-7921

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

970-400-7618

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

06/20/2018

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 363L00000X , with the licence number:  1759.1759 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 114129 . This is a "APRN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 1759 . This is a "RN" identifier , issued by the state of ( WY ) . This identifiers is of the category "OTHER".
• Identifier: 202101496NP-PP . This is a "APRN" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
• Identifier: 1759.1759 . This is a "APRN LICENSE" identifier , issued by the state of ( WY ) . This identifiers is of the category "OTHER".
• Identifier: 211974 . This is a "APRN" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".
• Identifier: 290563 . This is a "APRN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
• Identifier: AP61304725 . This is a "APRN" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: C-APN-.0105549-C-NP . This is a "APRN" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
• Identifier: RC-RXN.0103569-C0NP . This is a "APRN-RXN" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
• Identifier: 13203304-4405 . This is a "APRN" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
• Identifier: 202100632RN . This is a "RN" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
• Identifier: RN61279904 . This is a "RN" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".