Healthcare Provider Details

I. General information

NPI: 1871899013
Provider Name (Legal Business Name): BONNIE ELIZABETH SEELY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2011
Last Update Date: 07/28/2021
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 N 9TH AVE
VINTON IA
52349-2254
US

IV. Provider business mailing address

4070 HICKORY HILL LN
CEDAR RAPIDS IA
52403-3739
US

V. Phone/Fax

Practice location:
  • Phone: 319-472-6300
  • Fax: 319-472-2524
Mailing address:
  • Phone: 319-440-7923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberL-109356
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL109356
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: