Provider Demographics
NPI:1922306778
Name:SEEPAUL, JENNIFER S (LPN)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:S
Last Name:SEEPAUL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2384 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-3402
Mailing Address - Country:US
Mailing Address - Phone:718-495-0920
Mailing Address - Fax:718-922-7416
Practice Address - Street 1:2384 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-3402
Practice Address - Country:US
Practice Address - Phone:718-495-0920
Practice Address - Fax:718-922-7416
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303970-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse