Provider Demographics
NPI:1023730850
Name:SEATON, NYSSA ELISE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:NYSSA
Middle Name:ELISE
Last Name:SEATON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NYSSA
Other - Middle Name:ELISE
Other - Last Name:SEATON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4311 11TH AVE NE STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-6367
Mailing Address - Country:US
Mailing Address - Phone:206-616-4001
Mailing Address - Fax:
Practice Address - Street 1:6600 UNIVERSITY PKWY STE 202
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-9041
Practice Address - Country:US
Practice Address - Phone:239-415-7576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9118172363A00000X
FL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant