Provider Demographics
NPI:1679292643
Name:SEALY, ALLEYAH TIFFANY (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:ALLEYAH
Middle Name:TIFFANY
Last Name:SEALY
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5306 LAPIS PL APT 304
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4829
Mailing Address - Country:US
Mailing Address - Phone:813-454-8521
Mailing Address - Fax:
Practice Address - Street 1:5306 LAPIS PL APT 304
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4829
Practice Address - Country:US
Practice Address - Phone:813-454-5340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0004296-C-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics