Healthcare Provider Details

I. General information

NPI: 1013321306
Provider Name (Legal Business Name): LAURA SEAMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 06/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 W ELM ST
LEBANON MO
65536
US

IV. Provider business mailing address

341 HOSPITAL DR
LEBANON MO
65536-9217
US

V. Phone/Fax

Practice location:
  • Phone: 417-532-2805
  • Fax: 417-532-2848
Mailing address:
  • Phone: 417-532-7850
  • Fax: 417-532-2451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2014018651
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: