Provider Demographics
NPI:1184599482
Name:SEYMOUR, NICOLE L (RN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:L
Last Name:SEYMOUR
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 1:795 SHEEP PEN RD
Mailing Address - Street 2:
Mailing Address - City:UNADILLA
Mailing Address - State:NY
Mailing Address - Zip Code:13849-2112
Mailing Address - Country:US
Mailing Address - Phone:607-760-8408
Mailing Address - Fax:607-967-6345
Practice Address - Street 1:18 JULIAND ST
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:NY
Practice Address - Zip Code:13733-1025
Practice Address - Country:US
Practice Address - Phone:607-967-6313
Practice Address - Fax:607-967-6345
Is Sole Proprietor?:No
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY690928163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse