Provider Demographics
NPI:1396037396
Name:DRENNING, SARAH TERRY (C-PNP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:TERRY
Last Name:DRENNING
Suffix:
Gender:F
Credentials:C-PNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:TERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1393 WEIMER RD
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6253
Mailing Address - Country:US
Mailing Address - Phone:575-758-8651
Mailing Address - Fax:575-758-7811
Practice Address - Street 1:1393 WEIMER RD
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6253
Practice Address - Country:US
Practice Address - Phone:575-758-7074
Practice Address - Fax:575-758-7811
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP 01789363LP0200X
CO10108363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00051474Medicaid