Basic Information
Provider Information
NPI: 1003014853
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KRAY
FirstName: SARAH
MiddleName: CAUFIELD
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1135 N LINCOLN AVE STE 6
Address2:  
City: LOVELAND
State: CO
PostalCode: 805374877
CountryCode: US
TelephoneNumber: 9705990330
FaxNumber: 9702306811
Practice Location
Address1: 1135 N LINCOLN AVE STE 6
Address2:  
City: LOVELAND
State: CO
PostalCode: 80537
CountryCode: US
TelephoneNumber: 9705990330
FaxNumber: 9702306811
Other Information
ProviderEnumerationDate: 07/03/2007
LastUpdateDate: 09/04/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X2976COY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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