Provider Demographics
NPI:1689001216
Name:ROBINSON, SANDRA M (APRN,CNM)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:APRN,CNM
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:M
Other - Last Name:HAZZARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5546
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-5546
Mailing Address - Country:US
Mailing Address - Phone:801-397-6200
Mailing Address - Fax:801-397-6201
Practice Address - Street 1:185 S 400 E
Practice Address - Street 2:STE 100
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4801
Practice Address - Country:US
Practice Address - Phone:801-397-6200
Practice Address - Fax:801-397-6201
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6937161-4402367A00000X
UT6937161-4405363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU000092657Medicare PIN