Healthcare Provider Details

I. General information

NPI: 1114366036
Provider Name (Legal Business Name): SARAH J BRASSARD PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH J. THYEN PA

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 JACKSON ST
DENVER CO
80206-2761
US

IV. Provider business mailing address

1300 GARFIELD ST APT 1
DENVER CO
80206-2766
US

V. Phone/Fax

Practice location:
  • Phone: 303-388-4461
  • Fax: 303-270-2174
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4624
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10001559A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: