Healthcare Provider Details

I. General information

NPI: 1306588454
Provider Name (Legal Business Name): WILLIAM MICHAEL SEAMON MSN, APRN-CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2022
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 E GALBRAITH RD STE 212
CINCINNATI OH
45236-6704
US

IV. Provider business mailing address

4224 MATSON AVE
CINCINNATI OH
45236-2512
US

V. Phone/Fax

Practice location:
  • Phone: 513-829-1700
  • Fax:
Mailing address:
  • Phone: 513-417-3110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0031855
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.0031855
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.428017
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: