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Individual

CODY SEAMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
600 EAST BLVD, ELKHART, IN 46514-2483
(574) 294-2621
Mailing address
19620 GENTLE STREAM CIR, GOSHEN, IN 46528-6283
(208) 681-9477

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28247128
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
123219
IN

Other

Enumeration date
11/09/2018
Last updated
04/25/2022
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