Healthcare Provider Details

I. General information

NPI: 1265751994
Provider Name (Legal Business Name): MARY ANN SEEBECK RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2010
Last Update Date: 05/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 GREAT RD
NORTH SMITHFIELD RI
02896-7038
US

IV. Provider business mailing address

357 GREAT RD
NORTH SMITHFIELD RI
02896-7038
US

V. Phone/Fax

Practice location:
  • Phone: 401-274-1100
  • Fax: 401-453-7748
Mailing address:
  • Phone: 401-274-1100
  • Fax: 401-453-7748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN27025
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License NumberRN27025
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN27025
License Number StateRI
# 4
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN27025
License Number StateRI
# 5
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN27025
License Number StateRI
# 6
Primary TaxonomyN
Taxonomy Code163WX0002X
TaxonomyHigh-Risk Obstetric Registered Nurse
License NumberRN27025
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: