Profile - C-APN-C-NP
Profile - C-APN-C-NP
General Disclaimer:
The information posted on the Healthcare Professions Profile Program (HPPP) website was provided by applicants for an original license; applicants for reinstatement or reactivation of an existing license; as well as by those individuals renewing a license. While the Division believes the information to be reliable, human or mechanical error remains a possibility, as does the delay in the posting or updating of information. The Division makes no guarantee as to the accuracy or completeness of the information and the information is not verified by the HPPP staff. The Division will take action to obtain compliance with the requirements to provide accurate and timely information as required by law when information is received that indicates information required by law has not been provided or is not accurate.

Availability Disclaimer:
Healthcare professionals who have an inactive or lapsed license are not required to complete a Healthcare Professions Profile until they apply for reactivation or reinstatement. If you have questions about a missing Healthcare Professions Profile or any missing documents that should be listed, please contact the Healthcare Professions Profile Program at dora_dpo_hppp@state.co.us or 303-894-5942.

Malpractice Claims Disclaimer: Some studies have shown that there is no significant correlation between malpractice history and a healthcare professional's competence. At the same time, consumers should have access to malpractice information. To make the best healthcare decisions, you should view this information in perspective. You could miss an opportunity for high quality care by selecting a healthcare professional based solely on malpractice history. When considering malpractice data, please keep in mind: Malpractice histories tend to vary by profession and by specialty. Some professions or specialties are more likely than others to be the subject of litigation. You should take into account how long the healthcare professional has been in practice when considering malpractice averages. The incident causing the malpractice claim may have happened years before a payment is finally made. Sometimes, it takes a long time for a malpractice lawsuit to move through the legal system. Some healthcare professionals work primarily with high-risk patients. These healthcare professionals may have malpractice histories that are higher than average because they specialize in cases or patients who are at very high risk for problems. Settlement of a claim may occur for a variety of reasons that do not necessarily reflect negatively on the professional competence or conduct of the healthcare professional. A payment in settlement of a malpractice action or claim should not be construed as creating a presumption that malpractice has occurred. You may wish to discuss information provided, and malpractice generally, with your healthcare professional.



Name Heather M Luckenbaugh
Credential C-APN-C-NP

HPPP - C-NP Introduction

Healthcare Professions Profile



Please be aware that this profile is only for your Compact Nurse Practitioner - C-APN license. Do not provide information for other license types you hold on this profile. You will be required to complete a profile for every license you hold that is included in the profiling requirement.

All information provided in this profile must be updated within 30 days of any change of information unless your profession's statute says otherwise, or unless the question specifies otherwise.

 

HPPP GLOBAL - Location of Practice

Location of Practice



Are you currently practicing in the healthcare profession associated with this profile?

No
 

HPPP GLOBAL - Location of Practice If Yes

Location of Practice



Practice Locations:

Address  City  State  Zip Code  Phone Number 
 

HPPP - NURSING Education and Training

Education and Training



School or Education Level:

Masters Degree
 
Please enter the year your initial Degree was achieved: Only enter the year in YYYY format

2017
 

HPPP GLOBAL - Other Licenses

Other Licenses



Have you ever held, or do you currently hold any other licenses in this profession from any other state, country or province?

No
 

HPPP GLOBAL - Other Licenses if Yes

Other Licenses



Other Licenses:

State  License Status  Year Originally Issued 
 

HPPP GLOBAL - Board Certifications

Board Certifications



Do you hold any current Board Certifications?

Yes
 

HPPP - NURSING Board Certifications if Yes

Board Certifications



Board Certifications:

Certification 
ANCC - Family Nurse Practitioner
 

HPPP GLOBAL - Practice Specialties

Practice Specialties



Do you have a practice specialty in which you are appropriately trained and actively practicing?

No
 

HPPP - NURSING Practice Specialties if yes

Practice Specialties



Practice Specialties:

Specialty 
 

HPPP - RN APN Specialty

Advanced Practice Specialties



Do you hold an Advanced Practice Authority?

No
 

HPPP - RN APN Specialty if Yes

Advanced Practice Specialties



Advanced Practice Authority Specialty Area:


 

HPPP GLOBAL - CO Hospital Affiliations

Colorado Hospital Affiliations



Do you have a current affiliation or clinical privileges with any Colorado Hospital?

No
 

HPPP GLOBAL - CO Hospital Affiliations if Yes

Colorado Hospital Affiliations



Colorado Hospital Affiliations:

Hospital  Affiliation Type  City 
 

HPPP GLOBAL - Other Hospital Affiliations

Other Health Care Facilities and Out of State Hospital Affiliations



Do you have a current affiliation with any healthcare facility or a non-Colorado hospital?

No
 

HPPP GLOBAL - Other Hospital Affiliations If Yes

Other Health Care Facilities and Out of State Hospital Affiliations



Other Healthcare Facility Affiliations:

Facility  Affiliation Type  City  State 
 

HPPP GLOBAL - Business Ownership

Business Ownership



Do you have a current business ownership interest in any healthcare-related business?

No
 

HPPP GLOBAL - Business Ownership if Yes

Business Ownership



Business Ownership:

Business Name  City  State 
 

HPPP GLOBAL - Employer

Employer



Do you have an employer in the profession in which you are licensed or are applying for a license?

No
 

HPPP GLOBAL - Employer if Yes

Employer



Employer:

Employer Name  Address  City  State  Zip Code  Phone Number 
 

HPPP GLOBAL - Employment Contracts

Employment Contracts



Do you have a contract with any business whose mission relates to healthcare services or products where the value is greater than $5000 annually?

No
 

HPPP GLOBAL - Employment Contracts if Yes

Employment Contracts



Employment Contracts:

Entity Name  Length of Contract  Contract Position 
 

HPPP GLOBAL - Disciplinary Actions

Disciplinary Actions



Have you ever had public disciplinary action taken against your license by any board or licensing agency in any state or country?

No
 

HPPP GLOBAL - Disciplinary Actions if Yes

Disciplinary Actions



Disciplinary Actions:

Discipline Year  State 
 

HPPP GLOBAL - Restrictions and Suspensions

Restrictions and Suspensions



Have you ever entered into any agreement or stipulation to temporarily cease your practice or had a board order issued restricting or suspending your license?

No
 

HPPP GLOBAL - Restrictions and Suspensions if Yes

Restrictions and Suspensions



Restrictions and Suspensions:

Restriction Year  State 
 

HPPP GLOBAL - Healthcare Facility Actions

Healthcare Facility Actions



Since September 1, 1990, have you had any final actions resulting in involuntary limitations or probationary status on or reduction, nonrenewal, denial, revocation or suspension of medical staff membership or clinical privileges at a hospital or healthcare facility? You are not required to report a precautionary or administrative suspension unless you resigned your medical staff membership or clinical privileges while the suspension was pending.

No
 

HPPP GLOBAL - Healthcare Facility Actions if Yes

Healthcare Facility Actions



Healthcare Facility Actions:

Facility Name  City  State  Type of Action  Year of Action  Duration  Terms Complete 
 

HPPP GLOBAL - Termination of Employment

Termination of Employment



Have you ever been terminated by an employer for a reason that would be considered a violation of your profession's practice law?

No
 

HPPP GLOBAL - Termination of Employment if Yes

Termination of Employment



Terminations:

Employer Name  Termination Date 
 

HPPP GLOBAL - DEA Registration

DEA Registration Surrender



Have you ever had to involuntarily surrender your United States Drug Enforcement Agency Administration Registration?

No
 

HPPP GLOBAL - DEA Registration if Yes

DEA Registration Surrender



Year of Surrender:


 
 

HPPP GLOBAL - Convictions

Convictions



Since you were issued a license to practice your profession in any state or country, have you had any final criminal conviction(s) or plea arrangement(s) resulting from the commission or alleged commission of a felony or crime of moral turpitude in any jurisdiction?

No
 

HPPP GLOBAL - Convictions if Yes

Convictions



Convictions:

Year  State  Jurisdiction 
 

HPPP GLOBAL - Malpractice Claims

Malpractice Claims



Since September 1, 1990, have you had any final judgment, entered into a settlement, or paid an arbitration award for malpractice?

No
 

HPPP GLOBAL - Malpractice Claims if Yes

Malpractice Claims



Malpractice Claims:

Year  State  Claim Type  Arbitrator, Mediator or Court 
 

HPPP GLOBAL - Malpractice Carrier Refusal

Malpractice Carrier Refusal



Have you been denied liability insurance, or has your liability insurance coverage been limited, restricted or terminated by the insurance carrier?

No
 

HPPP GLOBAL - Malpractice Carrier Refusal if Yes

Malpractice Carrier Refusal



Malpractice Carrier Refusal:

Carrier Refusal Year 
 

HPPP GLOBAL - Optional Narrative

Optional Narrative



Optional Narrative:


 

HPPP GLOBAL - Attestation

Attestation



By submitting this Healthcare Professions Profile to the Division of Professions and Occupations you are attesting that:
  • You are the person identified in this profile; or
  • You are authorized to submit information on behalf of the person identified in this profile; and
  • The information contained herein is true and correct to the best of my knowledge.
 
Submission Date:
01/26/2018
 

Review
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