Provider Demographics
NPI:1447734751
Name:SAWYER, KURT COLTER (APRN)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:COLTER
Last Name:SAWYER
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027-3113
Mailing Address - Country:US
Mailing Address - Phone:435-590-6960
Mailing Address - Fax:
Practice Address - Street 1:1301 BERTHA HOWE AVE STE 1
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-7503
Practice Address - Country:US
Practice Address - Phone:702-346-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV814943363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily