Healthcare Provider Details

I. General information

NPI: 1639833783
Provider Name (Legal Business Name): SARAH DREW NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BUCK CREEK RD STE 200
AVON CO
81620-5428
US

IV. Provider business mailing address

2108 CRAZY HORSE CIR
EDWARDS CO
81632-8086
US

V. Phone/Fax

Practice location:
  • Phone: 709-266-3409
  • Fax: 970-926-6348
Mailing address:
  • Phone: 970-401-3944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0997039
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0997039
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: