Provider Demographics
NPI:1972577450
Name:FEY, SEA A (CNM)
Entity Type:Individual
Prefix:
First Name:SEA
Middle Name:A
Last Name:FEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 PLEASANT ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-1728
Mailing Address - Country:US
Mailing Address - Phone:515-309-6011
Mailing Address - Fax:515-309-6014
Practice Address - Street 1:1440 PLEASANT ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-1728
Practice Address - Country:US
Practice Address - Phone:515-309-6011
Practice Address - Fax:515-309-6014
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAB094409367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1421354Medicaid
IA0421354Medicaid
P95218Medicare UPIN
IA1421354Medicaid