Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 0198526 | CO |
Y | 363L00000X | Nurse Practitioner | F07181336 | CO |
NPI | 1316439052 |
---|---|
Provider Name | Sarah Wierda |
First Address | Highlands Ranch, CO 80129-2277 |
Second Address | Littleton, CO 80128-4571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2018 |
Last Update Date | 03/09/2021 |