Provider Demographics
NPI:1912005000
Name:SEABROOK, MAXINE ELIZABETH (CRNP)
Entity Type:Individual
Prefix:MS
First Name:MAXINE
Middle Name:ELIZABETH
Last Name:SEABROOK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:DAVIDSON
Other - Last Name:SEABROOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:56 SOUTHGATE AVE
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2830
Mailing Address - Country:US
Mailing Address - Phone:410-268-2192
Mailing Address - Fax:
Practice Address - Street 1:3 HARRY S TRUMAN PKWY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7031
Practice Address - Country:US
Practice Address - Phone:410-222-6625
Practice Address - Fax:410-222-6679
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR080394363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health