Provider Demographics
NPI:1467235911
Name:SEAGROVES-ROBBE, HALEY AMANDA (PA-C)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:AMANDA
Last Name:SEAGROVES-ROBBE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:AMANDA
Other - Last Name:DAVIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:41 BURLINGTON MALL RD CRITICAL CARE MEDICINE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:41 BURLINGTON MALL RD CRITICAL CARE MEDICINE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA100110363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant