Provider Demographics
NPI:1922498542
Name:SEGER, ANN MARIE (RN)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:SEGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 EMMA JANE
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70615-5222
Mailing Address - Country:US
Mailing Address - Phone:870-807-3528
Mailing Address - Fax:337-855-9773
Practice Address - Street 1:267 EMMA JANE
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70615-5222
Practice Address - Country:US
Practice Address - Phone:870-807-3528
Practice Address - Fax:337-855-9773
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR084668163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0000000Medicaid