Provider Demographics
NPI:1932405222
Name:SEIPP, MARY JANE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:JANE
Last Name:SEIPP
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5446 TILTED STONE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2430
Mailing Address - Country:US
Mailing Address - Phone:410-772-0652
Mailing Address - Fax:
Practice Address - Street 1:5446 TILTED STONE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2430
Practice Address - Country:US
Practice Address - Phone:410-772-0652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR073110363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner