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General NPI Number Information
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NPI Number | 1689283673
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Entity Type | Individual
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Provider Name | SARAH ANNE VIDAURRI NP
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Gender | Female
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 06/26/2021
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Provider Practice Location Address
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Address Line | 11684 HURON ST STE 104
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City | NORTHGLENN
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State | CO
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Zip | 80234-2924
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Country | US
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Telephone | 720-588-3249
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Fax |
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Provider Business Mailing Address
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Address Line | 11684 HURON ST STE 104
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City | NORTHGLENN
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State | CO
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Zip | 80234-2924
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Country | US
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Telephone | 720-588-3249
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Fax | 833-468-0039
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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 | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | RN.1617247
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0995942-NP
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License Number State | CO
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