Provider Demographics
NPI:1487835336
Name:SEERY, REBECCA SUE (LPN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUE
Last Name:SEERY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15620 COUNTY ROUTE 59
Mailing Address - Street 2:HALL DRIVE
Mailing Address - City:DEXTER
Mailing Address - State:NY
Mailing Address - Zip Code:13634-2090
Mailing Address - Country:US
Mailing Address - Phone:315-639-3186
Mailing Address - Fax:
Practice Address - Street 1:15620 COUNTY ROUTE 59
Practice Address - Street 2:HALL DRIVE
Practice Address - City:DEXTER
Practice Address - State:NY
Practice Address - Zip Code:13634-2090
Practice Address - Country:US
Practice Address - Phone:315-639-3186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY269770164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse