Provider Demographics
NPI:1992779573
Name:CANCRO, SARA (CRNP, CNM)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:CANCRO
Suffix:
Gender:F
Credentials:CRNP, CNM
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:BERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7285 S NEWPORT WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1615
Mailing Address - Country:US
Mailing Address - Phone:412-874-4301
Mailing Address - Fax:
Practice Address - Street 1:7285 S NEWPORT WAY
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1615
Practice Address - Country:US
Practice Address - Phone:412-874-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0003843-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
P26813Medicare UPIN
P26813Medicare UPIN