Provider Demographics
NPI:1720407497
Name:SAGE, HALLEY GAIL (MSN, APN, CPNP)
Entity Type:Individual
Prefix:
First Name:HALLEY
Middle Name:GAIL
Last Name:SAGE
Suffix:
Gender:F
Credentials:MSN, APN, CPNP
Other - Prefix:
Other - First Name:HALLEY
Other - Middle Name:GAIL
Other - Last Name:WEINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APN, CPNP
Mailing Address - Street 1:1805 SHEA CENTER DR STE 301
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2277
Mailing Address - Country:US
Mailing Address - Phone:303-779-3013
Mailing Address - Fax:
Practice Address - Street 1:10099 RIDGEGATE PKWY STE 290
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5534
Practice Address - Country:US
Practice Address - Phone:303-803-1005
Practice Address - Fax:303-798-3248
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4494363LP0200X
COAPN.0995267-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics