Provider Demographics
NPI:1750510152
Name:SENECA, JAMES PATRICK (NP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:SENECA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9155 CRESTWYN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-8501
Mailing Address - Country:US
Mailing Address - Phone:901-261-4848
Mailing Address - Fax:901-261-4867
Practice Address - Street 1:1803 JANE ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-1005
Practice Address - Country:US
Practice Address - Phone:337-519-6816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05883363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1888362Medicaid
LA1888362Medicaid