Provider Demographics
NPI:1225337298
Name:MIDWEST FAMILY CARE, LLC
Entity Type:Organization
Organization Name:MIDWEST FAMILY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SEEGER
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:573-270-8576
Mailing Address - Street 1:2387 W JACKSON BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-3024
Mailing Address - Country:US
Mailing Address - Phone:573-270-8576
Mailing Address - Fax:
Practice Address - Street 1:2387 W JACKSON BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755-3024
Practice Address - Country:US
Practice Address - Phone:573-270-8576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007018857363LA2200X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty