Healthcare Provider Details

I. General information

NPI: 1427218825
Provider Name (Legal Business Name): ANGELA MARIE SEWECKE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12311 PERRY HWY
WEXFORD PA
15090-8344
US

IV. Provider business mailing address

4135 BOARDMAN CANFIELD RD SUITE 101
CANFIELD OH
44406-9803
US

V. Phone/Fax

Practice location:
  • Phone: 878-332-4242
  • Fax: 878-332-4485
Mailing address:
  • Phone: 330-286-5330
  • Fax: 330-286-5396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN342556L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: