Provider Demographics
NPI:1285687186
Name:SEDLOCK, JOY (APRN-CNM, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:SEDLOCK
Suffix:
Gender:F
Credentials:APRN-CNM, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6785 MILL RD
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1832
Mailing Address - Country:US
Mailing Address - Phone:440-537-5777
Mailing Address - Fax:440-717-9787
Practice Address - Street 1:6785 MILL RD
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1832
Practice Address - Country:US
Practice Address - Phone:440-537-5777
Practice Address - Fax:440-717-9787
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN229502176B00000X
OHAPRN.CNP.024425363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2147251Medicaid
OHNM03172Medicare PIN
OHNM03171Medicare PIN
Q50925Medicare UPIN