Provider Demographics
NPI:1497449326
Name:SEIGEL, STACY SUSAN
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:SUSAN
Last Name:SEIGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 11TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1119
Mailing Address - Country:US
Mailing Address - Phone:240-925-8312
Mailing Address - Fax:
Practice Address - Street 1:1045 11TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1119
Practice Address - Country:US
Practice Address - Phone:240-925-8312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula