Provider Demographics
NPI:1730571209
Name:CARTMAN SEALS, CECELIA PATRICIAN (NP)
Entity type:Individual
Prefix:MS
First Name:CECELIA
Middle Name:PATRICIAN
Last Name:CARTMAN SEALS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:CECELIA
Other - Middle Name:PATRICIAN
Other - Last Name:GAMBRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92556-0455
Mailing Address - Country:US
Mailing Address - Phone:951-906-2545
Mailing Address - Fax:
Practice Address - Street 1:26590 KALMIA AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-1760
Practice Address - Country:US
Practice Address - Phone:951-906-2545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA278448-322363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner