=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487573093
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | 307 FAMILY HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2026
-----------------------------------------------------
Last Update Date | 07/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 616 N MYSTERY BRIDGE RD
-----------------------------------------------------
City | EVANSVILLE
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82636-9776
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-267-9779
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 51007
-----------------------------------------------------
City | CASPER
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82605-1007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-267-9779
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FNP-C
-----------------------------------------------------
Name | STEPHANY SEDMAK
-----------------------------------------------------
Credential | APRN, FNP-C
-----------------------------------------------------
Telephone | 307-267-9779
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------