Provider Demographics
NPI:1194335927
Name:CLARK, SARAH E (PHD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:CLARK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 E 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2560
Mailing Address - Country:US
Mailing Address - Phone:303-724-9561
Mailing Address - Fax:
Practice Address - Street 1:12700 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2560
Practice Address - Country:US
Practice Address - Phone:303-724-9561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician