Provider Demographics
NPI:1457756447
Name:SEIFERT, DAWN CATHERINE (CPNP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:CATHERINE
Last Name:SEIFERT
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29703 HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-8901
Mailing Address - Country:US
Mailing Address - Phone:586-573-9090
Mailing Address - Fax:
Practice Address - Street 1:29703 HOOVER RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-8901
Practice Address - Country:US
Practice Address - Phone:586-573-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704195678363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics