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Individual

MRS. YOLANDA S. SEDANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
132 5TH AVE WEST, JEROME, ID 83338
(208) 324-5286
(208) 324-5286
Mailing address
132 5TH AVE WEST, JEROME, ID 83338
(208) 324-5286
(208) 324-9815

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA902
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10000704157
BS
ID
05
808529900
ID
01
PA099
BC
ID
Enumeration date
10/02/2009
Last updated
02/27/2015
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