Provider Demographics
NPI:1952077224
Name:MAGDA, LUCY SEAGRAVES
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:SEAGRAVES
Last Name:MAGDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7780 BRIER CREEK PKWY STE 306
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-8831
Mailing Address - Country:US
Mailing Address - Phone:919-582-7272
Mailing Address - Fax:
Practice Address - Street 1:7780 BRIER CREEK PKWY STE 306
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-8831
Practice Address - Country:US
Practice Address - Phone:919-582-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016653363L00000X, 363LP0808X
TN238495163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse