Individual
JOANNE RUTH SEDLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4000 KRESGE WAY, LOUISVILLE, KY 40207-4605
(502) 473-2132
(502) 459-0923
Mailing address
PO BOX 34748, LOUISVILLE, KY 40232-4748
(502) 473-2132
(502) 459-0923
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1042912
KY
367500000X
Certified Registered Nurse Anesthetist
10010157
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
3003917
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000283601
BLUE SHIELD
KY
01
—
2818868000
PASSPORT ADVANTAGE
KY
01
—
430079853
RAILROAD MEDICARE
—
01
—
50013925
PASSPORT
KY
05
—
74006610
—
KY
Enumeration date
10/03/2005
Last updated
07/12/2023
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