Healthcare Provider Details

I. General information

NPI: 1447681069
Provider Name (Legal Business Name): SASHA RENE SEYMOUR C.N.A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2013
Last Update Date: 12/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 S INDEPENDENCE BLVD
NEW CASTLE DE
19720-4410
US

IV. Provider business mailing address

2 S INDEPENDENCE BLVD
NEW CASTLE DE
19720-4410
US

V. Phone/Fax

Practice location:
  • Phone: 302-543-1180
  • Fax:
Mailing address:
  • Phone: 302-543-1180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberDE000043701008
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: