| Doctor Name: | ANN R SEDLACEK |
| NPI Number: | 1629178835 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP |
| License Number: | 085075393N6 |
| Business Practice Address: | 311 Sw Main St Winston, OR - 974966570 |
| Business Phone Number: | 5414302594 |
| Business Fax Number: | 8883892677 |
| Mailing Address: | Po Box 771, WINSTON |
| State: | OR |
| Postal Code: | 974960771 |
| Phone Number: | 5414302594 |
| Fax Number: | 8883892677 |
| NPI Enumeration Date: | 09/25/2006 |
| NPI Last Update Date: | 12/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 085075393N6 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |