Provider Demographics
NPI:1245845627
Name:SEIWERT, JULIE ANNE (MT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:SEIWERT
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E SOUTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:POLK CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50226-2273
Mailing Address - Country:US
Mailing Address - Phone:515-205-0208
Mailing Address - Fax:
Practice Address - Street 1:200 E SOUTHSIDE DR
Practice Address - Street 2:
Practice Address - City:POLK CITY
Practice Address - State:IA
Practice Address - Zip Code:50226-2273
Practice Address - Country:US
Practice Address - Phone:515-205-0208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
166676246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist