Provider Demographics
NPI:1821621327
Name:SEYLLER, SABRINA A (NP)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:A
Last Name:SEYLLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 PINE TREE DR
Mailing Address - Street 2:
Mailing Address - City:BIGFORK
Mailing Address - State:MN
Mailing Address - Zip Code:56628-4346
Mailing Address - Country:US
Mailing Address - Phone:218-743-3232
Mailing Address - Fax:218-743-4223
Practice Address - Street 1:135 PINE TREE DR
Practice Address - Street 2:
Practice Address - City:BIGFORK
Practice Address - State:MN
Practice Address - Zip Code:56628-4346
Practice Address - Country:US
Practice Address - Phone:218-743-3232
Practice Address - Fax:218-743-4223
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7187363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily