Provider Demographics
NPI:1588100044
Name:SEELEY, JIMMIE WAYNE III (CRNA)
Entity type:Individual
Prefix:MR
First Name:JIMMIE
Middle Name:WAYNE
Last Name:SEELEY
Suffix:III
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:520 GOLDEN RIDGE RD APT 302
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-8905
Mailing Address - Country:US
Mailing Address - Phone:239-304-6585
Mailing Address - Fax:
Practice Address - Street 1:11600 W 2ND PL
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1527
Practice Address - Country:US
Practice Address - Phone:239-304-6585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COAPN.0992967-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered