Provider Demographics
NPI:1437494978
Name:SANFORD, CHRISTA MICHELLE (CNM)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:MICHELLE
Last Name:SANFORD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-873-5245
Mailing Address - Fax:303-873-5240
Practice Address - Street 1:1400 S POTOMAC ST
Practice Address - Street 2:#225
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4528
Practice Address - Country:US
Practice Address - Phone:303-873-5245
Practice Address - Fax:303-873-5240
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2013-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO990587367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91733324Medicaid
CO267123YLQFMedicare PIN