MEDICARE: MISS ALICIA L SEATS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN358133	OH
2	163WG0000X	General Practice Registered Nurse	RN358133	OH

General Provider Information

NPI Number	:	1255648838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ALICIA L SEATS RN

Provider Business Mailing Address
First Line	:	982 YELLOWSTONE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-1447
Country	:	US
Telephone Number	:	216-324-6884
Fax Number	:

Provider Business Practice Location Address
First Line	:	982 YELLOWSTONE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-1447
Country	:	US
Telephone Number	:	216-324-6884
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2010
Last Update Date	:	09/02/2010

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