Provider Demographics
NPI:1497065254
Name:GULDIN, SARA A (PA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:GULDIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:A
Other - Last Name:CROSIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:7951 E. MAPLEWOOD AVENUE SUITE 300
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111
Mailing Address - Country:US
Mailing Address - Phone:303-930-7800
Mailing Address - Fax:303-930-7860
Practice Address - Street 1:11750 W. 2ND PLACE SUITE 100
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228
Practice Address - Country:US
Practice Address - Phone:303-430-2700
Practice Address - Fax:303-430-2770
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054680363AM0700X
COPA.0004216363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO14836815Medicaid
CO14836815Medicaid