Provider Demographics
NPI:1013646470
Name:SEALES-ASH, MARISSA (RN)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:SEALES-ASH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 W 25TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-1000
Mailing Address - Country:US
Mailing Address - Phone:757-962-3262
Mailing Address - Fax:757-962-1625
Practice Address - Street 1:1035 W 25TH ST STE B
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-1000
Practice Address - Country:US
Practice Address - Phone:757-962-3262
Practice Address - Fax:757-962-1625
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001286985163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health