Provider Demographics
NPI:1407468317
Name:SEIFERT, MICAH SHIZUE ALIKA (DNP, CRNA)
Entity type:Individual
Prefix:
First Name:MICAH
Middle Name:SHIZUE ALIKA
Last Name:SEIFERT
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 SILVER SAGE DR APT 303
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-3971
Mailing Address - Country:US
Mailing Address - Phone:910-528-6524
Mailing Address - Fax:
Practice Address - Street 1:N2198 UNC HOSPITALS CB #7010
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-5136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261638163W00000X
NC129655AANA367500000X
NC6417367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse