Healthcare Provider Details

I. General information

NPI: 1285816785
Provider Name (Legal Business Name): CINDY L SEDLAK P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8111 DODGE ST STE. 220
OMAHA NE
68114-4129
US

IV. Provider business mailing address

13616 CALIFORNIA ST STE 100
OMAHA NE
68154-5336
US

V. Phone/Fax

Practice location:
  • Phone: 402-354-1320
  • Fax: 402-354-5965
Mailing address:
  • Phone: 402-496-0404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: