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NPI Code Detail

MEDICARE: MRS. JENNY SEABURG RN BSN

MEDICARE:  MRS. JENNY  SEABURG  RN BSN
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
1163WC1500XCommunity Health Registered Nurse22 581225NY

General Provider Information

NPI Number : 1336561422
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNY SEABURG RN BSN
Provider Business Mailing Address
First Line : 142 CHRISTINA DR
Second Line :
City : NORTH CHILI
State : NY
Zip : 14514-9751
Country : US
Telephone Number : 585-690-6669
Fax Number :
Provider Business Practice Location Address
First Line : 142 CHRISTINA DR
Second Line :
City : NORTH CHILI
State : NY
Zip : 14514-9751
Country : US
Telephone Number : 585-690-6669
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2014
Last Update Date : 01/09/2014

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