Provider Demographics
NPI:1033145248
Name:SEESKIN, CONNIE S (NP)
Entity Type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:S
Last Name:SEESKIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 WILLIAM HOWARD TAFT, PHYS DIV
Mailing Address - Street 2:2ND FL, CBO2-3, ATTN: CREDENTIALING
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-263-8571
Mailing Address - Fax:513-366-4480
Practice Address - Street 1:9250 BLUE ASH ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242
Practice Address - Country:US
Practice Address - Phone:513-792-7445
Practice Address - Fax:513-791-4042
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.06923-MP363LA2100X
OHRN-160618163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH272352575058OtherCARESOURCE
OH791974OtherANTHEM
OHP01190952OtherRAILROAD MEDICARE
OH447999OtherWELLCARE
OH1629638OtherGATEWAY HEALTH
OH2325111OtherMEDICAID
OH7959573OtherAETNA
OHH116691OtherMEDICARE
OHP10000743075OtherBUCKEYE
OHP61957Medicare UPIN