Provider Demographics
NPI:1962700898
Name:SEEPAYA, SIRIPEN (RN)
Entity type:Individual
Prefix:MISS
First Name:SIRIPEN
Middle Name:
Last Name:SEEPAYA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:SIRIPEN
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1041 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55041-2026
Mailing Address - Country:US
Mailing Address - Phone:651-345-9916
Mailing Address - Fax:
Practice Address - Street 1:1041 W ELM ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:MN
Practice Address - Zip Code:55041-2026
Practice Address - Country:US
Practice Address - Phone:651-345-9916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 156328-7163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse