Provider Demographics
NPI:1659063048
Name:SEDRAK, KATREEN
Entity Type:Individual
Prefix:
First Name:KATREEN
Middle Name:
Last Name:SEDRAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2232 VIKING CT
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37127-9800
Mailing Address - Country:US
Mailing Address - Phone:917-688-7432
Mailing Address - Fax:
Practice Address - Street 1:2232 VIKING CT
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37127-9800
Practice Address - Country:US
Practice Address - Phone:917-688-7432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)