Provider Demographics
NPI:1649705914
Name:SEIDLE, CATHERINE JULIA (NP)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:JULIA
Last Name:SEIDLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:CATHERINE
Other - Middle Name:JULIA
Other - Last Name:HOUSEFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:20 RIALTO DRIVE
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081
Mailing Address - Country:US
Mailing Address - Phone:828-290-4999
Mailing Address - Fax:
Practice Address - Street 1:11643 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-6604
Practice Address - Country:US
Practice Address - Phone:904-373-1661
Practice Address - Fax:904-619-6227
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPRN9495283363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health