Provider Demographics
NPI:1174007140
Name:SEYMOUR, MISSY JOY
Entity Type:Individual
Prefix:MS
First Name:MISSY
Middle Name:JOY
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-5406
Mailing Address - Country:US
Mailing Address - Phone:661-631-5895
Mailing Address - Fax:
Practice Address - Street 1:2905 EISSLER ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-1851
Practice Address - Country:US
Practice Address - Phone:661-631-5210
Practice Address - Fax:661-871-7007
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA558990163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool