Healthcare Provider Details

I. General information

NPI: 1477480234
Provider Name (Legal Business Name): MICHAEL JOSEPH SEEHAFER REGISTERED NURSE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E VETERANS ST
TOMAH WI
54660-3105
US

IV. Provider business mailing address

500 E VETERANS ST
TOMAH WI
54660-3105
US

V. Phone/Fax

Practice location:
  • Phone: 608-672-6971
  • Fax:
Mailing address:
  • Phone: 608-672-6971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number163701-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: