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General NPI Number Information
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NPI Number | 1184680431
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Entity Type | Individual
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Provider Name | TRUDIE DIANNE SEIRAFI PA
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Gender | Female
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 1510 FOREST AVE
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City | MONTGOMERY
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State | AL
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Zip | 36106-1517
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Country | US
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Telephone | 334-834-6422
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 240635
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City | MONTGOMERY
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State | AL
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Zip | 36124-0635
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Country | US
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Telephone | 205-435-0938
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA-201
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA-201
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License Number State | AL
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