Provider Demographics
NPI:1891455804
Name:GALLEGOS, SARAH M (MSN, CNM)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:GALLEGOS
Suffix:
Gender:F
Credentials:MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10290 RIDGEGATE CIR
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5331
Mailing Address - Country:US
Mailing Address - Phone:303-788-8300
Mailing Address - Fax:
Practice Address - Street 1:10290 RIDGEGATE CIR
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5331
Practice Address - Country:US
Practice Address - Phone:303-788-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-19
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997096-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CORN.0190998OtherRN LICENSE
CORXN.0106123-CNMOtherRXN LICENSE
COAPN.09997096-CNMOtherCNM LICENSE