Melissa Suzanne Bagwell-Seifert, CRNP
Individual provider Active NPI Pediatric Nurse Practitioner · Cullman, AL
NPI 1568614170 · NPPES record last updated Jul 23, 2016
Key facts
- NPI
- 1568614170
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 1-087518 (AL)
- Practice address
- 1965 Al Highway 157
Suite B
Cullman, AL 35058-0672 - Phone
- (256) 775-2722
- Fax
- (256) 775-2648
- NPI assigned
- Oct 14, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-087518 | AL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cullman Pediatrics, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 1-087518 | AL | Yes |
Addresses
Primary practice location
1965 Al Highway 157
Suite B
Cullman, AL 35058-0672
Mailing address
1965 Al Highway 157
Suite B
Cullman, AL 35058-0672
Phone (256) 775-2722
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 182072 | Medicaid | AL | |
| 1-087518 | Other | AL | ALABAMA BOARD OF NURSING LICENSE NUMBER |
Other providers in Cullman, AL
- Ashley Drug Company of Cullman Inc
- Jeffery Rayford Ashley
- Associated Medical Specialties, Inc
- Ansley Corine Ayers
- Virgil Thomas Baccus
- Dan Bailey
- Julie Bailey
- Samantha Suzanne Bailey
- Shelby Bailey
- Kathy Baker
All providers in Cullman, AL · Pediatric Nurse Practitioner in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.