=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689989832
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINA MARIE SEAL PHARM D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2010
-----------------------------------------------------
Last Update Date | 08/12/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 31150 HWY 441
-----------------------------------------------------
City | HOLDEN
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70744-4211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-507-9007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31150 HWY 441
-----------------------------------------------------
City | HOLDEN
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70744-4211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-507-9007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 18465
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------