Provider Demographics
NPI:1538832472
Name:ZELAZNY, SYDNEY A (LPN)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:A
Last Name:ZELAZNY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25005 DUNHAM AVE
Mailing Address - Street 2:
Mailing Address - City:VENETA
Mailing Address - State:OR
Mailing Address - Zip Code:97487-9791
Mailing Address - Country:US
Mailing Address - Phone:541-510-1547
Mailing Address - Fax:
Practice Address - Street 1:25005 DUNHAM AVE
Practice Address - Street 2:
Practice Address - City:VENETA
Practice Address - State:OR
Practice Address - Zip Code:97487-9791
Practice Address - Country:US
Practice Address - Phone:541-510-1547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202101887LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse