Provider Demographics
NPI:1477110534
Name:SEELY, JENSYN L (CRNP)
Entity Type:Individual
Prefix:
First Name:JENSYN
Middle Name:L
Last Name:SEELY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 GEARHART RD
Mailing Address - Street 2:
Mailing Address - City:TURBOTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17772-9024
Mailing Address - Country:US
Mailing Address - Phone:570-651-2787
Mailing Address - Fax:
Practice Address - Street 1:360 WHITE DEER RUN RD
Practice Address - Street 2:
Practice Address - City:ALLENWOOD
Practice Address - State:PA
Practice Address - Zip Code:17810-9268
Practice Address - Country:US
Practice Address - Phone:570-980-2475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020215363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health