Basic Information
| Provider Information | |||||||||
| NPI: | 1033145248 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEESKIN | ||||||||
| FirstName: | CONNIE | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 237 WILLIAM HOWARD TAFT, PHYS DIV | ||||||||
| Address2: | 2ND FL, CBO2-3, ATTN: CREDENTIALING | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452192906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132638571 | ||||||||
| FaxNumber: | 5133664480 | ||||||||
| Practice Location | |||||||||
| Address1: | 9250 BLUE ASH ROAD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137927445 | ||||||||
| FaxNumber: | 5137914042 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 02/18/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | COA.06923-MP | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 163WX0800X | RN-160618 | OH | N | Nursing Service Providers | Registered Nurse | Orthopedic |
ID Information
| ID | Type | State | Issuer | Description | 272352575058 | 01 | OH | CARESOURCE | OTHER | 791974 | 01 | OH | ANTHEM | OTHER | P01190952 | 01 | OH | RAILROAD MEDICARE | OTHER | 447999 | 01 | OH | WELLCARE | OTHER | 1629638 | 01 | OH | GATEWAY HEALTH | OTHER | 2325111 | 01 | OH | MEDICAID | OTHER | 7959573 | 01 | OH | AETNA | OTHER | H116691 | 01 | OH | MEDICARE | OTHER | P10000743075 | 01 | OH | BUCKEYE | OTHER |