Provider Demographics
NPI:1104955863
Name:SEAWELL, JANET L (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:L
Last Name:SEAWELL
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3853 ROSECRANS ST
Mailing Address - Street 2:MAIL STOP P-533
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-3115
Mailing Address - Country:US
Mailing Address - Phone:619-692-8204
Mailing Address - Fax:619-692-5502
Practice Address - Street 1:3853 ROSECRANS ST
Practice Address - Street 2:MAIL STOP P-533
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3115
Practice Address - Country:US
Practice Address - Phone:619-692-8520
Practice Address - Fax:619-692-5502
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 254678163WA2000X
CA4148376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No376G00000XNursing Service Related ProvidersNursing Home Administrator