Provider Demographics
NPI:1265877864
Name:KLATT, SANDRA WOODWARD (RN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:WOODWARD
Last Name:KLATT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7122 GOLD NUGGET DR
Mailing Address - Street 2:
Mailing Address - City:NIWOT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-8511
Mailing Address - Country:US
Mailing Address - Phone:303-803-0464
Mailing Address - Fax:
Practice Address - Street 1:10065 E HARVARD AVE
Practice Address - Street 2:STE 400
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5968
Practice Address - Country:US
Practice Address - Phone:303-614-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO176947163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse