Healthcare Provider Details

I. General information

NPI: 1831055672
Provider Name (Legal Business Name): GARRISON SEAMAN FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/24/2025
Last Update Date: 01/01/2026
Certification Date: 01/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N BREAZEALE AVE
MOUNT OLIVE NC
28365-1603
US

IV. Provider business mailing address

201 N BREAZEALE AVE
MOUNT OLIVE NC
28365-1603
US

V. Phone/Fax

Practice location:
  • Phone: 919-658-4954
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5023715
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: