Provider Demographics
NPI:1881289254
Name:SEDLAK, EMILY M
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:SEDLAK
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 1:1639 WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-1568
Mailing Address - Country:US
Mailing Address - Phone:440-221-2445
Mailing Address - Fax:
Practice Address - Street 1:2130 W CENTRAL AVE STE 103
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3819
Practice Address - Country:US
Practice Address - Phone:419-291-3900
Practice Address - Fax:419-479-6451
Is Sole Proprietor?:No
Enumeration Date:2021-03-07
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027315363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily