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Individual

MS. KIMBERLY JO SEDBROOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2 CARLSON PKWY N STE 100, PLYMOUTH, MN 55447-4467
(952) 473-1286
(952) 473-7281
Mailing address
2 CARLSON PKWY N STE 240, PLYMOUTH, MN 55447-4485
(763) 367-7110

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
11222
MN
363A00000X
Physician Assistant
Primary
11222
MN
363A00000X
Physician Assistant
3284-23
WI
363AM0700X
Medical Physician Assistant
PA.0004420
CO

Other

Enumeration date
11/16/2012
Last updated
03/01/2024
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