Provider Demographics
NPI:1871528760
Name:SEITZ, SCOTT ALAN (APRN-BC)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALAN
Last Name:SEITZ
Suffix:
Gender:M
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 PROFESSIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1116
Mailing Address - Country:US
Mailing Address - Phone:859-355-5253
Mailing Address - Fax:859-788-3916
Practice Address - Street 1:138 PROFESSIONAL AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1116
Practice Address - Country:US
Practice Address - Phone:859-355-5253
Practice Address - Fax:859-788-3916
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1084387163W00000X
KY3003555207Q00000X, 261QR1300X, 363LF0000X
KY3555P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1084387OtherRN LICENSE#
KY3003555OtherAPRN LICENSE
KYMS1772171OtherDEA