1366498081 NPI number — MRS. DENISE ANN SARTZ MS, AOCN, FNP-C

Table of content: MRS. DENISE ANN SARTZ MS, AOCN, FNP-C (NPI 1366498081)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366498081 NPI number — MRS. DENISE ANN SARTZ MS, AOCN, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SARTZ
Provider First Name:
DENISE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, AOCN, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366498081
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
214 E. 23RD STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHEYENNE
Provider Business Mailing Address State Name:
WY
Provider Business Mailing Address Postal Code:
82001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
307-633-7777
Provider Business Mailing Address Fax Number:
307-432-6641

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
214 E. 23RD STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHEYENNE
Provider Business Practice Location Address State Name:
WY
Provider Business Practice Location Address Postal Code:
82001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
307-633-7777
Provider Business Practice Location Address Fax Number:
307-432-6641
Provider Enumeration Date:
05/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  91400 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 16274.1045 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 65127013 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1366498081 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".




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