Provider Demographics
NPI:1053134502
Name:SEILER LUCAS, BRIANNA GRACE I (CPHT)
Entity type:Individual
Prefix:MS
First Name:BRIANNA
Middle Name:GRACE
Last Name:SEILER LUCAS
Suffix:I
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 16TH AVE SW APT 301
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-4146
Mailing Address - Country:US
Mailing Address - Phone:320-212-0250
Mailing Address - Fax:
Practice Address - Street 1:301 BECKER AVE SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3302
Practice Address - Country:US
Practice Address - Phone:320-231-4250
Practice Address - Fax:320-231-4850
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN747567183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician