Healthcare Provider Details

I. General information

NPI: 1053341198
Provider Name (Legal Business Name): JACQUELINE L SEACAT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 WESTFIELD RD
NOBLESVILLE IN
46062-8901
US

IV. Provider business mailing address

PO BOX 869
NOBLESVILLE IN
46061-0869
US

V. Phone/Fax

Practice location:
  • Phone: 317-776-3854
  • Fax: 317-776-3854
Mailing address:
  • Phone: 317-770-6900
  • Fax: 317-770-6911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71001245A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: