Provider Demographics
NPI:1679669659
Name:SEEFELDT, SANDRA LEE (RNC APNP)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LEE
Last Name:SEEFELDT
Suffix:
Gender:F
Credentials:RNC APNP
Other - Prefix:MISS
Other - First Name:SANDRA
Other - Middle Name:LEE
Other - Last Name:DAHL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1409 HOGEBOOM AVENUE
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701
Mailing Address - Country:US
Mailing Address - Phone:715-832-9945
Mailing Address - Fax:
Practice Address - Street 1:STUDENT HEALTH SERVICE UW EAU CLAIRE
Practice Address - Street 2:CREST WELLNESS CENTER
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701
Practice Address - Country:US
Practice Address - Phone:715-836-4311
Practice Address - Fax:715-836-5979
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIAPNP 599033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner