Provider Demographics
NPI:1063699924
Name:SANFORD, PATRICIA CATHERINE (ACNP-BC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:CATHERINE
Last Name:SANFORD
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:CATHERINE
Other - Last Name:SANFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ACNP-BC
Mailing Address - Street 1:3959 SPRUCE RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-9524
Mailing Address - Country:US
Mailing Address - Phone:719-687-4555
Mailing Address - Fax:719-687-4555
Practice Address - Street 1:1699 MEDICAL CENTER PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-5700
Practice Address - Country:US
Practice Address - Phone:719-632-7101
Practice Address - Fax:719-632-4468
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR855352363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care