Provider Demographics
NPI:1467797456
Name:SEELEY, RAVI KUMAR
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:KUMAR
Last Name:SEELEY
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 1:9021 STANLEN RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-2349
Mailing Address - Country:US
Mailing Address - Phone:612-309-6414
Mailing Address - Fax:
Practice Address - Street 1:9021 STANLEN RD
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-2349
Practice Address - Country:US
Practice Address - Phone:612-309-6414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide