Provider Demographics
NPI:1699303362
Name:SEEWALD, KATHRYN SULLIVAN (APRN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:SULLIVAN
Last Name:SEEWALD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4129 N ARMENIA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6436
Mailing Address - Country:US
Mailing Address - Phone:813-879-3699
Mailing Address - Fax:813-873-8469
Practice Address - Street 1:4129 N ARMENIA AVE STE B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6436
Practice Address - Country:US
Practice Address - Phone:813-879-3699
Practice Address - Fax:813-873-8469
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11030377363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care