Healthcare Provider Details

I. General information

NPI: 1386811578
Provider Name (Legal Business Name): ERIK ANDERSON SEAGLE RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S STERLING ST
MORGANTON NC
28655-3938
US

IV. Provider business mailing address

212 ASHEVILLE ST APT A
MORGANTON NC
28655-4376
US

V. Phone/Fax

Practice location:
  • Phone: 828-433-2548
  • Fax:
Mailing address:
  • Phone: 828-443-3516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number158667
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: