Provider Demographics
NPI:1306690896
Name:SEESE, LISA MARIE
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:SEESE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55
Mailing Address - Street 2:
Mailing Address - City:ROSEMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26424-0055
Mailing Address - Country:US
Mailing Address - Phone:304-677-4732
Mailing Address - Fax:
Practice Address - Street 1:503 MORGANTOWN AVE STE 120
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-4384
Practice Address - Country:US
Practice Address - Phone:304-363-7375
Practice Address - Fax:304-471-2488
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker