Provider Demographics
NPI:1528955374
Name:SEMEYN, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SEMEYN
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3735 MONA KAI BLVD BLDG 1
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49444-3742
Mailing Address - Country:US
Mailing Address - Phone:616-644-0281
Mailing Address - Fax:
Practice Address - Street 1:3735 MONA KAI BLVD BLDG 1
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-3742
Practice Address - Country:US
Practice Address - Phone:616-644-0281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704161709163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse