Provider Demographics
NPI:1528821568
Name:SEGUIN, ANGEL MARIE (BSN, RN)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:MARIE
Last Name:SEGUIN
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36542 UNION LAKE RD APT 10
Mailing Address - Street 2:
Mailing Address - City:HARRISON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48045-6673
Mailing Address - Country:US
Mailing Address - Phone:313-459-3664
Mailing Address - Fax:
Practice Address - Street 1:36542 UNION LAKE RD APT 10
Practice Address - Street 2:
Practice Address - City:HARRISON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48045-6673
Practice Address - Country:US
Practice Address - Phone:313-459-3664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704221971163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics