Provider Demographics
NPI:1437023892
Name:SEABRON, KEVIN MARQUETTE
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:MARQUETTE
Last Name:SEABRON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 MARION BARRY AVE SE APT 712
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5125
Mailing Address - Country:US
Mailing Address - Phone:972-854-2107
Mailing Address - Fax:
Practice Address - Street 1:2300 MARION BARRY AVE SE APT 712
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5125
Practice Address - Country:US
Practice Address - Phone:972-854-2107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC193400000X376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty