Healthcare Provider Details

I. General information

NPI: 1811064454
Provider Name (Legal Business Name): SARAH LYNETTE NORMANDIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH NORMANDIN MD

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 RIDGEGATE PARKWAY
LONE TREE CO
80124-9810
US

IV. Provider business mailing address

P.O. BOX 17284
DENVER CO
80217-7284
US

V. Phone/Fax

Practice location:
  • Phone: 720-225-1900
  • Fax: 303-306-7753
Mailing address:
  • Phone: 303-306-7783
  • Fax: 303-306-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberRT 1425
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA104005
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD 60109786
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD 28818
License Number StateOR
# 5
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberDR.0058446
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: