Healthcare Provider Details

I. General information

NPI: 1053709774
Provider Name (Legal Business Name): JAMIE LEE SESZKO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2015
Last Update Date: 01/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 PLAZA DR
SAINT CLAIRSVILLE OH
43950-6700
US

IV. Provider business mailing address

PO BOX 84 54967 MAPLE AVE
LANSING OH
43934-0084
US

V. Phone/Fax

Practice location:
  • Phone: 740-526-0731
  • Fax:
Mailing address:
  • Phone: 740-310-7586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA16721-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: