Basic Information
| Provider Information | |||||||||
| NPI: | 1316456999 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEDERBERG | ||||||||
| FirstName: | TAYLOR | ||||||||
| MiddleName: | ALICIA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5200 DTC PKWY STE 400 | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801112719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037450000 | ||||||||
| FaxNumber: | 3037081834 | ||||||||
| Practice Location | |||||||||
| Address1: | 5200 DTC PKWY STE 400 | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801112719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037450000 | ||||||||
| FaxNumber: | 3037081834 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2017 | ||||||||
| LastUpdateDate: | 01/02/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WM0705X | RN.0166479 | CO | N | Nursing Service Providers | Registered Nurse | Medical-Surgical | 363LG0600X | 993519 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.