NPI | 1639793094 |
---|---|
Former Name | MACY E SELVIG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11007201) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: FL APRN11007201) |
Enumeration Date | 2020-06-02 |
Last Update Date | 2025-07-02 |