Provider Demographics
NPI:1962941666
Name:SEELEY, MICHAEL K (NP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:K
Last Name:SEELEY
Suffix:
Gender:M
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:10010 KENNERLY RD
Mailing Address - Street 2:3 SOUTHBRIDGE
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2106
Mailing Address - Country:US
Mailing Address - Phone:314-525-1328
Mailing Address - Fax:314-525-1378
Practice Address - Street 1:10010 KENNERLY RD
Practice Address - Street 2:3 SOUTHBRIDGE
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2106
Practice Address - Country:US
Practice Address - Phone:314-525-1328
Practice Address - Fax:314-525-1378
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2017-04-11
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Provider Licenses
StateLicense IDTaxonomies
MO2016040775363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care