Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APN.0992782-NP | CO |
NPI | 1053856740 |
---|---|
Provider Name | Sarah Tanner |
First Address | Englewood, CO 80113-3180 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2017 |
Last Update Date | 04/01/2017 |