Basic Information
| Provider Information | |||||||||
| NPI: | 1487396602 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NESLADEK | ||||||||
| FirstName: | SABRINA | ||||||||
| MiddleName: | LORAINE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6903 GRANDVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | ARVADA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800022617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7203352670 | ||||||||
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| Practice Location | |||||||||
| Address1: | 420 DELAWARE ST. SE | ||||||||
| Address2: | MMC 293 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126240990 | ||||||||
| FaxNumber: | 6126253238 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2022 | ||||||||
| LastUpdateDate: | 05/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.