Provider Demographics
NPI:1952734972
Name:CAROLINE SEIGNON
Entity Type:Organization
Organization Name:CAROLINE SEIGNON
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIGNON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYCHIATRIC NURSE NP
Authorized Official - Phone:678-697-4468
Mailing Address - Street 1:20205 AUTUMN FERN AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2915
Mailing Address - Country:US
Mailing Address - Phone:678-697-4498
Mailing Address - Fax:813-315-9097
Practice Address - Street 1:20205 AUTUMN FERN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647
Practice Address - Country:US
Practice Address - Phone:678-697-4498
Practice Address - Fax:813-315-9097
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:N/A
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9329726261QM0801X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health