Provider Demographics
NPI:1598594608
Name:SEAGERT, JENNIFER W
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:W
Last Name:SEAGERT
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 1:443 N RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43566-1456
Mailing Address - Country:US
Mailing Address - Phone:419-283-2306
Mailing Address - Fax:
Practice Address - Street 1:443 N RIVER RD
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43566-1456
Practice Address - Country:US
Practice Address - Phone:419-283-2306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant