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Individual

NICOLE Y. SEABECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
(260) 420-0817
Mailing address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
(260) 420-0817

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28114255A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0068623
OH
05
201052120
IN
Enumeration date
12/01/2011
Last updated
10/20/2022
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