Basic Information
Provider Information
NPI: 1053326512
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEDLER
FirstName: KAY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: MSC 10 5580
Address2: 1 UNIVERSITY OF NEW MEXICO
City: ALBUQUERQUE
State: NM
PostalCode: 871310001
CountryCode: US
TelephoneNumber: 5052722245
FaxNumber: 5052726385
Practice Location
Address1: 2211 LOMAS BLVD NE
Address2: AMBULATORY CARE CENTER - 4
City: ALBUQUERQUE
State: NM
PostalCode: 871062745
CountryCode: US
TelephoneNumber: 5052722245
FaxNumber: 5052721109
Other Information
ProviderEnumerationDate: 07/30/2006
LastUpdateDate: 10/03/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000X233NMY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

ID Information
IDTypeStateIssuerDescription
9208005NM MEDICAID


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