Provider Demographics
NPI:1871367375
Name:SEEVERS, ALLYSON JAE
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:JAE
Last Name:SEEVERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5034 CLEAR RIDGE DR SE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-8384
Mailing Address - Country:US
Mailing Address - Phone:616-710-0058
Mailing Address - Fax:
Practice Address - Street 1:5034 CLEAR RIDGE DR SE
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MI
Practice Address - Zip Code:49301-8384
Practice Address - Country:US
Practice Address - Phone:616-710-0058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant