Provider Demographics
NPI:1871899013
Name:SEELY, BONNIE ELIZABETH (ARNP)
Entity type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:ELIZABETH
Last Name:SEELY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4070 HICKORY HILL LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-3739
Mailing Address - Country:US
Mailing Address - Phone:319-440-7923
Mailing Address - Fax:
Practice Address - Street 1:504 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:IA
Practice Address - Zip Code:52349-2254
Practice Address - Country:US
Practice Address - Phone:319-472-6300
Practice Address - Fax:319-472-2524
Is Sole Proprietor?:No
Enumeration Date:2011-02-06
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAL109356363LP0808X
IAL-109356363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA719260665Medicare PIN