Basic Information
| Provider Information | |||||||||
| NPI: | 1679206494 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEAY | ||||||||
| FirstName: | TARA | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 206 10TH ST | ||||||||
| Address2: | |||||||||
| City: | GROTTOES | ||||||||
| State: | VA | ||||||||
| PostalCode: | 244411901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5402710604 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 22 S GREENE ST | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212011590 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103288667 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2022 | ||||||||
| LastUpdateDate: | 07/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 0001238969 | VA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.