Provider Demographics
NPI:1073826723
Name:SEAMAN, JENNAFER (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:JENNAFER
Middle Name:
Last Name:SEAMAN
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27100 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1109
Mailing Address - Country:US
Mailing Address - Phone:216-831-6500
Mailing Address - Fax:216-839-6698
Practice Address - Street 1:27100 CEDAR RD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-1109
Practice Address - Country:US
Practice Address - Phone:216-831-6500
Practice Address - Fax:216-839-6698
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD6439133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4366958Medicaid
OH0318000001Medicare NSC
OH365094Medicare Oscar/Certification