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General NPI Number Information
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NPI Number | 1235561127
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Entity Type | Individual
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Provider Name | KATHLEEN DORIS SENECAL FNP-C, MSN, CWCN
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Gender | Female
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Dates
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Enumeration Date | 08/02/2013
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 2755 DAGAN CIR
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City | NORTH POLE
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State | AK
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Zip | 99705-6498
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Country | US
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Telephone | 907-750-9721
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Fax |
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Provider Business Mailing Address
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Address Line | 2755 DAGAN CIR
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City | NORTH POLE
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State | AK
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Zip | 99705-6498
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Country | US
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Telephone | 907-750-9721
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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 | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 30133
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 146162
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License Number State | AK
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