Provider Demographics
NPI:1265488977
Name:ZEEDYK, JANET L (PA-C)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:ZEEDYK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 WEST WAYNE STREET
Mailing Address - Street 2:
Mailing Address - City:PAULDING
Mailing Address - State:OH
Mailing Address - Zip Code:45879
Mailing Address - Country:US
Mailing Address - Phone:419-399-1104
Mailing Address - Fax:419-399-5560
Practice Address - Street 1:608 ERIE ST
Practice Address - Street 2:
Practice Address - City:ANTWERP
Practice Address - State:OH
Practice Address - Zip Code:45813-9465
Practice Address - Country:US
Practice Address - Phone:419-258-5641
Practice Address - Fax:419-258-2711
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50002083363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZEPA26981Medicare PIN