Provider Demographics
NPI:1366955338
Name:SEBASTIAN, GINEY EDASSERIPARAMBIL (RN)
Entity type:Individual
Prefix:MRS
First Name:GINEY
Middle Name:EDASSERIPARAMBIL
Last Name:SEBASTIAN
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 1:2274 S ISABELL ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-6459
Mailing Address - Country:US
Mailing Address - Phone:303-868-5027
Mailing Address - Fax:
Practice Address - Street 1:2274 S ISABELL ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-6459
Practice Address - Country:US
Practice Address - Phone:720-922-3717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0184688163WM0705X, 363LP0808X
COAPN.1000563-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical