Provider Demographics
NPI:1053862474
Name:BEUERLEIN, SEGUIN WARWICK (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SEGUIN
Middle Name:WARWICK
Last Name:BEUERLEIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SEGUIN
Other - Middle Name:LEE
Other - Last Name:WARWICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:9711 SHERRILL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-3330
Mailing Address - Country:US
Mailing Address - Phone:865-373-5050
Mailing Address - Fax:865-373-5051
Practice Address - Street 1:9711 SHERRILL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-3330
Practice Address - Country:US
Practice Address - Phone:865-373-5050
Practice Address - Fax:865-373-5051
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1194363A00000X
NC0010-07287363A00000X
FL9113993363AM0700X
TN3141363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical