Provider Demographics
NPI:1477000578
Name:SEAY, JASON STEPHEN (APRN)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:STEPHEN
Last Name:SEAY
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 W I 35 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-8550
Mailing Address - Country:US
Mailing Address - Phone:405-757-3365
Mailing Address - Fax:405-757-3498
Practice Address - Street 1:2017 W I 35 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-8550
Practice Address - Country:US
Practice Address - Phone:405-757-3365
Practice Address - Fax:405-757-3498
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK106205163W00000X, 363LP0200X
OK105205363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty