Provider Demographics
NPI:1558911966
Name:CAMPBELL, SARA D (AGACNP/FNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:D
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:AGACNP/FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 PEAK ONE DR STE 340
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443-5948
Mailing Address - Country:US
Mailing Address - Phone:970-668-9772
Mailing Address - Fax:
Practice Address - Street 1:360 PEAK ONE DR STE 340
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443-5948
Practice Address - Country:US
Practice Address - Phone:970-668-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995033-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner