Provider Demographics
NPI:1457338402
Name:SEIBERT, DONNA M (NP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:SEIBERT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1561
Mailing Address - Country:US
Mailing Address - Phone:781-340-1702
Mailing Address - Fax:781-340-0931
Practice Address - Street 1:1221 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1561
Practice Address - Country:US
Practice Address - Phone:781-340-1702
Practice Address - Fax:781-340-0931
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA110313363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP3171OtherBLUE CROSS BLUE SHIELD
MAP30415Medicare UPIN
MANP3171Medicare PIN