MEDICARE: WANDA LYNN CSAKY CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	NP06588	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053399139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WANDA LYNN CSAKY CNP

Provider Business Mailing Address
First Line	:	1193 NORTON AVE
Second Line	:	STE. A.
City	:	NORTON
State	:	OH
Zip	:	44203-9516
Country	:	US
Telephone Number	:	330-825-0847
Fax Number	:	330-825-9569

Provider Business Practice Location Address
First Line	:	1193 NORTON AVE
Second Line	:	STE. A.
City	:	NORTON
State	:	OH
Zip	:	44203-9516
Country	:	US
Telephone Number	:	330-825-0847
Fax Number	:	330-825-9569

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	09/20/2021

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