Provider Demographics
NPI:1619567856
Name:SEEHAFER, AIMIE (PA-C)
Entity type:Individual
Prefix:
First Name:AIMIE
Middle Name:
Last Name:SEEHAFER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AIMIE
Other - Middle Name:
Other - Last Name:WIECHMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23441 LIME VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-5990
Mailing Address - Country:US
Mailing Address - Phone:612-310-7589
Mailing Address - Fax:
Practice Address - Street 1:1230 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5066
Practice Address - Country:US
Practice Address - Phone:507-625-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13586363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty