MEDICARE: CHRISTINE SEIDELL APRN

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	363LF0000X	Family Nurse Practitioner	10874	CT

General Provider Information

NPI Number	:	1639895626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE SEIDELL APRN

Provider Business Mailing Address
First Line	:	6 GALLOPING HILL RD
Second Line	:
City	:	BETHEL
State	:	CT
Zip	:	06801-1658
Country	:	US
Telephone Number	:	914-384-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 STONY HILL RD
Second Line	:
City	:	BETHEL
State	:	CT
Zip	:	06801-1053
Country	:	US
Telephone Number	:	203-874-3682
Fax Number	:

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

Provider Enumeration Date	:	10/12/2022
Last Update Date	:	10/12/2022

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Directions to “ CHRISTINE SEIDELL APRN” Practice Location

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