Provider Demographics
NPI:1871568451
Name:SEYMOUR, JENNIFER (CNM)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ALLEGHENY CTR FL 7
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5255
Mailing Address - Country:US
Mailing Address - Phone:412-330-5068
Mailing Address - Fax:412-330-5844
Practice Address - Street 1:2580 HAYMAKER RD STE 201
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3500
Practice Address - Country:US
Practice Address - Phone:412-856-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000679-1367A00000X
PAMW010062367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014337170001Medicaid
NY01904374Medicaid
PAGU039794OtherPA MEDICARE GROUP
NYRA9082Medicare PIN
PAGU039794OtherPA MEDICARE GROUP
S94072Medicare UPIN