Provider Demographics
NPI:1376393736
Name:SEAY-MORELAND, ANTWANAI D
Entity Type:Individual
Prefix:
First Name:ANTWANAI
Middle Name:D
Last Name:SEAY-MORELAND
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 1:6983 OLD TROY PIKE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-2745
Mailing Address - Country:US
Mailing Address - Phone:786-620-0750
Mailing Address - Fax:
Practice Address - Street 1:6983 TROY PIKE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-2745
Practice Address - Country:US
Practice Address - Phone:786-620-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH602777350124376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide