Healthcare Provider Details

I. General information

NPI: 1275175739
Provider Name (Legal Business Name): DEBORAH SEYMOUR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2019
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 S MAIN ST STE D
TORRINGTON CT
06790-6448
US

IV. Provider business mailing address

21 GARNET RD
MANCHESTER CT
06040-7112
US

V. Phone/Fax

Practice location:
  • Phone: 860-266-4340
  • Fax: 203-646-5086
Mailing address:
  • Phone: 860-999-3503
  • Fax: 203-646-5086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number8538
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number8538
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: