Healthcare Provider Details

I. General information

NPI: 1841508603
Provider Name (Legal Business Name): CHRISTY LYNN SEFTAR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS CHRISTY LYNN LYONS

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 CHERRYWOOD DR
WAUKESHA WI
53188-2741
US

IV. Provider business mailing address

1515 CHERRYWOOD DR
WAUKESHA WI
53188-2741
US

V. Phone/Fax

Practice location:
  • Phone: 414-530-2118
  • Fax:
Mailing address:
  • Phone: 414-530-2118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number161588-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: