Provider Demographics
NPI:1275842247
Name:SEGLIE, SUSAN MAUREEN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MAUREEN
Last Name:SEGLIE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 S ROUSE ST STE E
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-6621
Mailing Address - Country:US
Mailing Address - Phone:620-232-2890
Mailing Address - Fax:620-232-5819
Practice Address - Street 1:2711 S ROUSE ST STE E
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6621
Practice Address - Country:US
Practice Address - Phone:620-232-2890
Practice Address - Fax:620-232-5819
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily