Provider Demographics
NPI:1982177200
Name:SEERING, MICHELLE RENE (RN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENE
Last Name:SEERING
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 1:2408 1/2 HUTTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87402-1951
Mailing Address - Country:US
Mailing Address - Phone:262-804-1323
Mailing Address - Fax:
Practice Address - Street 1:US HWY 64 OLD HIGH SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SHIPROCK
Practice Address - State:NM
Practice Address - Zip Code:87420-1199
Practice Address - Country:US
Practice Address - Phone:505-368-5163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10783930163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse