Provider Demographics
NPI:1730682949
Name:SAGENDORF, AMY
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:SAGENDORF
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 1:2625 S COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5910
Mailing Address - Country:US
Mailing Address - Phone:315-278-2028
Mailing Address - Fax:
Practice Address - Street 1:2625 S COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5910
Practice Address - Country:US
Practice Address - Phone:720-524-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator