Provider Demographics
NPI:1073205639
Name:SEIDEL, JOAN C (MA, BSN, RN, CIC)
Entity Type:Individual
Prefix:MISS
First Name:JOAN
Middle Name:C
Last Name:SEIDEL
Suffix:
Gender:F
Credentials:MA, BSN, RN, CIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E ERIE ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-3633
Mailing Address - Country:US
Mailing Address - Phone:330-678-8109
Mailing Address - Fax:330-678-2820
Practice Address - Street 1:201 E ERIE ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-3633
Practice Address - Country:US
Practice Address - Phone:330-678-8109
Practice Address - Fax:330-678-2820
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN207963163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator