Healthcare Provider Details

I. General information

NPI: 1538294145
Provider Name (Legal Business Name): NICOLE H SEDENKA PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR CC 101 GH
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

1004 ROLLING CREEK DR NE
CEDAR RAPIDS IA
52402-7447
US

V. Phone/Fax

Practice location:
  • Phone: 319-384-6800
  • Fax:
Mailing address:
  • Phone: 319-294-9214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19833
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: