Provider Demographics
NPI:1801674551
Name:ZEDIKER, MANDY MICHELLE
Entity type:Individual
Prefix:
First Name:MANDY
Middle Name:MICHELLE
Last Name:ZEDIKER
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 1:1223 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3435
Mailing Address - Country:US
Mailing Address - Phone:419-651-2298
Mailing Address - Fax:
Practice Address - Street 1:1223 SMITH RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3435
Practice Address - Country:US
Practice Address - Phone:419-651-2298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide