Provider Demographics
NPI:1164039988
Name:SIX, SETH THOMAS (FNP-C)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:THOMAS
Last Name:SIX
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 N CAMINO MERCADO STE 7
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5759
Mailing Address - Country:US
Mailing Address - Phone:520-836-5538
Mailing Address - Fax:844-772-0049
Practice Address - Street 1:560 N CAMINO MERCADO STE 7
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5759
Practice Address - Country:US
Practice Address - Phone:520-836-5538
Practice Address - Fax:844-772-0049
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID65849363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner