Provider Demographics
NPI:1598157570
Name:SANDERFER, KODY C (NP)
Entity type:Individual
Prefix:
First Name:KODY
Middle Name:C
Last Name:SANDERFER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 SHEA CENTER DR STE 450
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2255
Mailing Address - Country:US
Mailing Address - Phone:720-493-9006
Mailing Address - Fax:
Practice Address - Street 1:9218 KIMMER DR STE 207
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6733
Practice Address - Country:US
Practice Address - Phone:720-493-9006
Practice Address - Fax:720-242-7520
Is Sole Proprietor?:No
Enumeration Date:2015-02-27
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19673363LA2200X
COAPN.0998548-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health