Provider Demographics
NPI:1679237283
Name:SEEFELD, LAURA LYNN (RN CDCES)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:SEEFELD
Suffix:
Gender:F
Credentials:RN CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W3891 SUNNY RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:WI
Mailing Address - Zip Code:53019-1262
Mailing Address - Country:US
Mailing Address - Phone:920-579-0468
Mailing Address - Fax:
Practice Address - Street 1:1818 N. MEADE ST.
Practice Address - Street 2:APPLETON MEDICAL CENTER
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911
Practice Address - Country:US
Practice Address - Phone:920-831-5935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI110669-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse