Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 364910 | CA |
NPI | 1003808585 |
---|---|
Provider Name | Anne Ellison Seaman |
First Address | Martinez, CA 94553-4614 |
Second Address | Martinez, CA 94553-4614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P 18563 | (02) | CA |