Provider Demographics
NPI:1669513461
Name:WINN, SANDRA K (NP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:WINN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 E. WOODMEN RD, STE 320
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923
Mailing Address - Country:US
Mailing Address - Phone:719-591-6666
Mailing Address - Fax:719-573-0731
Practice Address - Street 1:6011 E. WOODMEN RD, STE 320
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923
Practice Address - Country:US
Practice Address - Phone:719-591-6666
Practice Address - Fax:719-573-0731
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO78669363LX0001X
CO78669.207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO78669OtherSTATE ID
CO04014221Medicaid
CO04014221Medicaid
COMW0230362OtherDEA