Provider Demographics
NPI:1619660180
Name:SEVY, ABIGAIL LEE
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LEE
Last Name:SEVY
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 1:5447 MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25840-6872
Mailing Address - Country:US
Mailing Address - Phone:304-574-1141
Mailing Address - Fax:304-574-1151
Practice Address - Street 1:1962 CLIFFTOP RD
Practice Address - Street 2:
Practice Address - City:LOOKOUT
Practice Address - State:WV
Practice Address - Zip Code:25868
Practice Address - Country:US
Practice Address - Phone:304-575-9609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV109595163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse