Provider Demographics
NPI:1538312897
Name:SEALE, JEAN ROUNTREE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:ROUNTREE
Last Name:SEALE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 LAURELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209-2265
Mailing Address - Country:US
Mailing Address - Phone:940-435-0080
Mailing Address - Fax:
Practice Address - Street 1:1605 LAURELWOOD DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76209-2265
Practice Address - Country:US
Practice Address - Phone:940-435-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007311363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily