Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APN.0993184-NP | CO |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 4704282020 | MI |
N | 363LP0200X | Nurse Practitioner - Pediatrics | APN.0993184-NP | CO |
NPI | 1033569488 |
---|---|
Provider Name | Sarah Moultrie |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2016 |
Last Update Date | 26/07/2019 |