Provider Demographics
NPI:1750895306
Name:SANAY, MICHELLE
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SANAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8012 FOX RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-5005
Mailing Address - Country:US
Mailing Address - Phone:720-926-8151
Mailing Address - Fax:
Practice Address - Street 1:8012 FOX RIDGE CT
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-5005
Practice Address - Country:US
Practice Address - Phone:720-926-8151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9284240163WP0808X
CO1636371163WP0808X
FL11001715-APRN363LP0808X
CORXN.0103864-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAPN.0994477OtherCO APN
CO1636371OtherRN CO
FL9284240OtherFL RN
2018070756OtherANCC
FL11001715OtherAPRN FL
CORXN.0103864-NPOtherDORA RXN-NP
CORXN.0103864-NPOtherDORA RXN-NP