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General NPI Number Information
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NPI Number | 1477545374
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Entity Type | Individual
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Provider Name | SANDRA LOPINA DEVENY M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 1905 BLAKE AVE SUITE 101
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-4288
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Country | US
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Telephone | 970-945-2840
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Fax | 970-945-2893
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Provider Business Mailing Address
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Address Line | 1905 BLAKE AVE STE 101
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-4206
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Country | US
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Telephone | 970-945-2840
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Fax | 970-945-2893
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 46945
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 35055564
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 46945
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License Number State | CO
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