Provider Demographics
NPI:1215592233
Name:EVERILL, SARAH ELAINE (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELAINE
Last Name:EVERILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 BLUE SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-2004
Mailing Address - Country:US
Mailing Address - Phone:970-619-4695
Mailing Address - Fax:970-498-6745
Practice Address - Street 1:1525 BLUE SPRUCE DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2004
Practice Address - Country:US
Practice Address - Phone:970-619-4695
Practice Address - Fax:970-498-6745
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-06
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996840-NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health