Healthcare Provider Details

I. General information

NPI: 1114809977
Provider Name (Legal Business Name): SARA JANE KNISLEY PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 N ACADEMY BLVD STE 3
COLORADO SPRINGS CO
80917-5115
US

IV. Provider business mailing address

3220 N ACADEMY BLVD STE 3
COLORADO SPRINGS CO
80917-5115
US

V. Phone/Fax

Practice location:
  • Phone: 719-747-2084
  • Fax: 719-931-1323
Mailing address:
  • Phone: 719-747-2084
  • Fax: 719-931-1323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1001732-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: