MEDICARE: JENNIFER MARIE SEEGARS 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1204235	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	243159	AK

General Provider Information

NPI Number	:	1659256006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MARIE SEEGARS APRN

Provider Business Mailing Address
First Line	:	11758 SGM CHRISTIAN FLEETWOOD ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79908-3226
Country	:	US
Telephone Number	:	808-445-3398
Fax Number	:

Provider Business Practice Location Address
First Line	:	11758 SGM CHRISTIAN FLEETWOOD ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79908-3226
Country	:	US
Telephone Number	:	808-445-3398
Fax Number	:

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

Provider Enumeration Date	:	08/06/2025
Last Update Date	:	10/10/2025

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