Provider Demographics
NPI:1740715135
Name:SEWARD, CHRISTIE MARLENE (APRN)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:MARLENE
Last Name:SEWARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:MARLENE
Other - Last Name:PING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:454 LAGRANGE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30222-1303
Mailing Address - Country:US
Mailing Address - Phone:706-845-3599
Mailing Address - Fax:706-845-3660
Practice Address - Street 1:1497 LAFAYETTE PKWY
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30241-2552
Practice Address - Country:US
Practice Address - Phone:706-880-7335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN158900363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology