Provider Demographics
NPI:1366950925
Name:SEIFFERT, DEBRA K (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:K
Last Name:SEIFFERT
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 MADISON AVE STE G5
Mailing Address - Street 2:
Mailing Address - City:GRANITE CITY
Mailing Address - State:IL
Mailing Address - Zip Code:62040-4641
Mailing Address - Country:US
Mailing Address - Phone:618-798-8460
Mailing Address - Fax:314-773-1802
Practice Address - Street 1:2044 MADISON AVE STE G5
Practice Address - Street 2:
Practice Address - City:GRANITE CITY
Practice Address - State:IL
Practice Address - Zip Code:62040-4641
Practice Address - Country:US
Practice Address - Phone:618-798-8460
Practice Address - Fax:314-773-1802
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO141052163W00000X
MO2018024068363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse