Provider Demographics
NPI:1144966219
Name:MCCANN, SARA ELISE
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ELISE
Last Name:MCCANN
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 1:1218 N WASHINGTON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-5206
Mailing Address - Country:US
Mailing Address - Phone:804-387-4847
Mailing Address - Fax:
Practice Address - Street 1:8401 S CHAMBERS RD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9498
Practice Address - Country:US
Practice Address - Phone:130-337-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program