Provider Demographics
NPI:1134614712
Name:SEYMOUR, ELIZABETH M (APRN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 US HIGHWAY 2 W STE 2
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3413
Mailing Address - Country:US
Mailing Address - Phone:406-314-6400
Mailing Address - Fax:406-314-6401
Practice Address - Street 1:1327 US HIGHWAY 2 W STE 2
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3413
Practice Address - Country:US
Practice Address - Phone:406-314-6400
Practice Address - Fax:406-314-6401
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-127106363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily