| Doctor Name: | MARTHA SEPULVADO |
| NPI Number: | 1437130192 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 1377240011 |
| Business Practice Address: | 550 Pope Ave Fort Leavenworth, KS - 660272332 |
| Business Phone Number: | 9136846348 |
| Business Fax Number: | |
| Mailing Address: | 4512 Park 10 Ct, LEAVENWORTH |
| State: | KS |
| Postal Code: | 660485554 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/09/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | 1377240011 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |