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NPI Code Detail

MEDICARE: KYLE SADLER

MEDICARE: KYLE SADLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramMN

General Provider Information

NPI Number : 1801727508
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE SADLER
Provider Business Mailing Address
First Line : PO BOX 47159
Second Line :
City : PLYMOUTH
State : MN
Zip : 55447-0159
Country : US
Telephone Number : 763-559-3779
Fax Number : 763-450-3986
Provider Business Practice Location Address
First Line : 14700 28TH AVE N STE 20
Second Line :
City : PLYMOUTH
State : MN
Zip : 55447-4876
Country : US
Telephone Number : 763-559-3779
Fax Number : 763-450-3986
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2026
Last Update Date : 05/29/2026

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Directions to “ KYLE SADLER ” Practice Location

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