Provider Demographics
NPI:1659036770
Name:SEEVERS, MACQUELLE (FNP)
Entity type:Individual
Prefix:
First Name:MACQUELLE
Middle Name:
Last Name:SEEVERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 S GRANT ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-1610
Mailing Address - Country:US
Mailing Address - Phone:260-227-1117
Mailing Address - Fax:
Practice Address - Street 1:2709 S GRANT ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-1610
Practice Address - Country:US
Practice Address - Phone:260-227-1117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997053-NP207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine