Healthcare Provider Details

I. General information

NPI: 1619871159
Provider Name (Legal Business Name): MARK ANTHONY SEYMOUR II RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 HARRISBURG PIKE STE 310
LANCASTER PA
17601-2644
US

IV. Provider business mailing address

6570 HOLLOW DR
EAST PETERSBURG PA
17520-1005
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-3232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN691956
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: