Healthcare Provider Details

I. General information

NPI: 1417460213
Provider Name (Legal Business Name): SARAH PHYLLIS JANINE PFEIFFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2017
Last Update Date: 05/12/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 DRY CREEK DR STE 200
LONGMONT CO
80503-6409
US

IV. Provider business mailing address

82 LARKSPUR LN # 1557
AVON CO
81620-5606
US

V. Phone/Fax

Practice location:
  • Phone: 720-279-9098
  • Fax: 303-248-3589
Mailing address:
  • Phone: 303-564-6284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0005233
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: