Healthcare Provider Details

I. General information

NPI: 1578873576
Provider Name (Legal Business Name): ASHLEY M SEKADLO FNP- BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2010
Last Update Date: 07/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 N 2ND ST
MILWAUKEE WI
53212
US

IV. Provider business mailing address

126 W RESERVOIR AVE
MILWAUKEE WI
53212-3726
US

V. Phone/Fax

Practice location:
  • Phone: 414-312-1437
  • Fax:
Mailing address:
  • Phone: 414-312-1437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number162797-30
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8223
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: