Provider Demographics
NPI:1366593881
Name:SEAMAN, REGINA A (PA-C)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:A
Last Name:SEAMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 HARLON CT
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-9221
Mailing Address - Country:US
Mailing Address - Phone:910-565-2899
Mailing Address - Fax:910-565-2899
Practice Address - Street 1:2300 RAMSEY ST
Practice Address - Street 2:VETERANS AFFAIRS MEDICAL CENTER
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-3856
Practice Address - Country:US
Practice Address - Phone:910-483-9727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02244363AM0700X, 363AM0700X
NY010573363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100511206Medicaid