=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821424334
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARA JEAN SCHAEFER N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2013
-----------------------------------------------------
Last Update Date | 04/13/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2315 E HARMONY RD SUITE 110
-----------------------------------------------------
City | FORT COLLINS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80528-8620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-482-4373
-----------------------------------------------------
Fax | 970-484-5682
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2315 E HARMONY RD SUITE 110
-----------------------------------------------------
City | FORT COLLINS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80528-8620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-482-4373
-----------------------------------------------------
Fax | 970-484-5682
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 364SN0800X
-----------------------------------------------------
Taxonomy Name | Neuroscience Clinical Nurse Specialist
-----------------------------------------------------
License Number | APN.0992014-NP
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 306654
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | APN.0992014-NP
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 363LG0600X
-----------------------------------------------------
Taxonomy Name | Gerontology Nurse Practitioner
-----------------------------------------------------
License Number | APN.0992014-NP
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------