Provider Demographics
NPI:1720759822
Name:DRISH, SEAIRA MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:SEAIRA
Middle Name:MARIE
Last Name:DRISH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15785 250TH ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:IA
Mailing Address - Zip Code:52570-8122
Mailing Address - Country:US
Mailing Address - Phone:319-461-7047
Mailing Address - Fax:
Practice Address - Street 1:15785 250TH ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:IA
Practice Address - Zip Code:52570-8122
Practice Address - Country:US
Practice Address - Phone:319-461-7047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA165854363LF0000X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health