Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 0024166782 | VA |
NPI | 1003018128 |
---|---|
Provider Name | Ms. Renee D Seaman |
First Address | Richmond, VA 23298-0102 |
Second Address | Richmond, VA 23298-0102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0024166782 | STATE LICENSE (01) | VA |