Provider Demographics
NPI:1417460213
Name:PFEIFFER, SARAH PHYLLIS JANINE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:PHYLLIS JANINE
Last Name:PFEIFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 LARKSPUR LN # 1557
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CO
Mailing Address - Zip Code:81620-5606
Mailing Address - Country:US
Mailing Address - Phone:303-564-6284
Mailing Address - Fax:
Practice Address - Street 1:1630 DRY CREEK DR STE 200
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-6409
Practice Address - Country:US
Practice Address - Phone:303-564-6284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0005233363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant