Provider Demographics
NPI:1740871011
Name:SEEBACK, ABIGAIL MARIE (RN)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MARIE
Last Name:SEEBACK
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 1:720 E NEW HAVEN AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-5575
Mailing Address - Country:US
Mailing Address - Phone:321-724-4545
Mailing Address - Fax:
Practice Address - Street 1:720 E NEW HAVEN AVE STE 111
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-5575
Practice Address - Country:US
Practice Address - Phone:321-724-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-29
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9392065163W00000X
FLAPRN11011431363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse