Provider Demographics
NPI:1669613758
Name:SEDGELEY, SHARON LYNNE (NP)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:LYNNE
Last Name:SEDGELEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:LYNNE
Other - Last Name:LEONARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:260 S KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-1086
Mailing Address - Country:US
Mailing Address - Phone:303-239-7119
Mailing Address - Fax:303-239-7088
Practice Address - Street 1:260 S KIPLING ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1086
Practice Address - Country:US
Practice Address - Phone:303-239-7119
Practice Address - Fax:303-239-7088
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47189363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO27277500Medicaid