Provider Demographics
NPI:1265751994
Name:SEEBECK, MARY ANN (RN, BSN)
Entity type:Individual
Prefix:MS
First Name:MARY ANN
Middle Name:
Last Name:SEEBECK
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 GREAT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02896-7038
Mailing Address - Country:US
Mailing Address - Phone:401-274-1100
Mailing Address - Fax:401-453-7748
Practice Address - Street 1:357 GREAT RD
Practice Address - Street 2:
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-7038
Practice Address - Country:US
Practice Address - Phone:401-274-1100
Practice Address - Fax:401-453-7748
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN27025163W00000X, 163WC1400X, 163WD0400X, 163WP2201X, 163WW0101X, 163WX0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1400XNursing Service ProvidersRegistered NurseCollege Health
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk