Provider Demographics
NPI:1740065457
Name:SEALL, ALYSON BARBARA (RN)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:BARBARA
Last Name:SEALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 S MOPAC EXPY APT 918
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7966
Mailing Address - Country:US
Mailing Address - Phone:480-634-3987
Mailing Address - Fax:
Practice Address - Street 1:2301 S MOPAC EXPY APT 918
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7966
Practice Address - Country:US
Practice Address - Phone:480-634-3987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1094940163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse