Provider Demographics
NPI:1821329251
Name:COHN, SARAH R (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:R
Last Name:COHN
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 1:223 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:LEADVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80461
Mailing Address - Country:US
Mailing Address - Phone:719-293-7199
Mailing Address - Fax:855-861-6548
Practice Address - Street 1:223 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:LEADVILLE
Practice Address - State:CO
Practice Address - Zip Code:80461
Practice Address - Country:US
Practice Address - Phone:719-293-7199
Practice Address - Fax:855-861-6548
Is Sole Proprietor?:No
Enumeration Date:2010-01-25
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002375363A00000X
CO2985363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2985OtherSTATE OF COLORADO DEPARTMENT OF REGULATORY AGENCIES
CT002375OtherCONNECTICUT STATE DEPARTMENT OF HEALTH, PHYSICIAN ASSISTANT LICENSE NUMBER