Provider Demographics
NPI:1497954143
Name:SCHNEIDER, SARA JEAN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:JEAN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6169 S. BALSAM WAY
Mailing Address - Street 2:SUITE 190
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-3000
Mailing Address - Country:US
Mailing Address - Phone:303-933-8240
Mailing Address - Fax:
Practice Address - Street 1:6169 S BALSAM WAY
Practice Address - Street 2:SUITE 190
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3062
Practice Address - Country:US
Practice Address - Phone:303-933-8240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2437363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO97403229Medicaid
CO97403229Medicaid