Healthcare Provider Details

I. General information

NPI: 1609680552
Provider Name (Legal Business Name): SEANA LOUISE MARKHAM AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/15/2025
Certification Date: 02/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 VALLEY HEALTH WAY
FRONT ROYAL VA
22630-6480
US

IV. Provider business mailing address

120 BRENTWOOD COMMONS WAY STE 510
BRENTWOOD TN
37027-2028
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-4334
  • Fax:
Mailing address:
  • Phone: 817-919-3557
  • Fax: 817-754-1588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024192487
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: