Provider Demographics
NPI:1477868156
Name:SEDLAK, STEPHANIE A (CNM)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:SEDLAK
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:A
Other - Last Name:HAASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 5TH ST NE
Mailing Address - Street 2:STE. 6
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-3017
Mailing Address - Country:US
Mailing Address - Phone:330-745-4748
Mailing Address - Fax:330-745-4970
Practice Address - Street 1:201 5TH ST NE
Practice Address - Street 2:STE. 6
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-3017
Practice Address - Country:US
Practice Address - Phone:330-745-4748
Practice Address - Fax:330-745-4970
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.330942-COA1163W00000X
OHCOA.11677.NM176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse