Provider Demographics
NPI:1205641982
Name:SEELY, STEPHEN
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:SEELY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:SEELY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3820 MAJESTIC AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4100
Mailing Address - Country:US
Mailing Address - Phone:308-227-4468
Mailing Address - Fax:
Practice Address - Street 1:3820 MAJESTIC AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4100
Practice Address - Country:US
Practice Address - Phone:308-227-4468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion