KATRINA LEA SELSOR (NPI# 1073020673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1073020673 |
Entity Type | Individual |
Full Name | KATRINA LEA SELSOR |
Credential | NP |
Practice Address |
155 Village Dr Sparta MO 65753-8104 |
Mailing Address |
2183 Johnson Rd Sparta MO 65753-8813 |
Practice Telephone | 4173644203 |
Practice Fax Number | 4176344505 |
Mailing Telephone | 4178802505 |
Mailing Fax Number | 4176344505 |
Enumeration Date | 2018-01-04 |
Last Update Date | 2018-01-04 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
2018000302 | MO | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
155 VILLAGE DR |
City | SPARTA |
State | MO |
Zip Code | 65753-8104 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215932488 | Arthur Joe Cohn | Internal Medicine | 155 Village Dr, Sparta, MO 65753-8104 | 2005-06-15 |
1689289282 | Eric B Hines | Family Medicine | 155 Village Dr, Sparta, MO 65753-8104 | 2020-09-10 |
1003389941 | Tara N Loveland | Nurse Practitioner | 155 Village Dr, Sparta, MO 65753-8104 | 2019-01-03 |
1972620383 | Bridges Medical Services P.C. | Clinic/Center | 155 Village Dr, Sparta, MO 65753 | 2007-03-23 |
1770689747 | John J Magnuson | Pediatrics | 155 Village Dr, Sparta, MO 65753-8104 | 2006-09-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043790504 | Regional Services | Nurse Practitioner | 8520 Mo-14, Sparta, MO 65753 | 2018-08-15 |
1780801936 | Daniel Douglas Mccool | Speech-Language Pathologist | School Dist R 3 Sparta, 113 Division, Sparta, MO 65753-0160 | 2007-04-19 |
1255527990 | Mary Neal | Speech-Language Pathologist | 217 Division St, Sparta R IIi, Sparta, MO 65753-0160 | 2007-09-17 |
1689758872 | Rural Healthcare Providers Inc. | Family Medicine | 515 Hugh Ave, Sparta, MO 65753-0449 | 2006-10-24 |
1063425650 | Paul Boyd Glynn | Family Medicine | 515 Hugh Ave, Sparta, MO 65753-1220 | 2006-08-14 |
1043839491 | Ehsan Zandifar | Family Medicine | 515 Hugh Ave, Sparta, MO 65753-1220 | 2020-04-15 |
1750708335 | Betty S. Bruce | Nurse Practitioner | 515 Hugh Ave, Sparta, MO 65753-1220 | 2014-03-21 |
1811391717 | Sgoh Acquisition, Inc. | Clinic/Center | 155 Village Drive, Sparta, MO 65753-8104 | 2014-10-21 |
1710433297 | Erica Neff | Registered Nurse | 407 Nutmeg Ct, Sparta, MO 65753-8503 | 2016-08-25 |
1699740001 | Family Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 7154 State Highway 14 E, Sparta, MO 65753-8939 | 2006-02-20 |
Find all providers in zip 65753 |
Taxonomy Code | 363LP2300X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083980593 | Healthstat Inc | Nurse Practitioner | 1889 Hwy 21 S., Sparta, NC 28675 | 2012-03-29 |
1316509334 | James Clark Childress | Nurse Practitioner | 457 Vista Dr, Sparta, TN 38583-1360 | 2019-06-29 |
1689668105 | Kimerly A Neal | Nurse Practitioner | 401 Sewell Dr, Sparta, TN 38583-1223 | 2005-09-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801493275 | Destemona Bozhani-marte | Nurse Practitioner | 5804 Sw Bray Rd, Clarksdale, MO 64430-9176 | 2020-10-07 |
1437760675 | Justin Lucas Sweetin | Nurse Practitioner | 7727 Weston Pl, Richmond Heights, MO 63117-2018 | 2020-08-12 |
1962043802 | Bonne Terre Healthcare Clinic, LLC | Nurse Practitioner | 11 S Division St Ste A, Bonne Terre, MO 63628-1701 | 2019-10-02 |
1720639354 | Anne Nicole Dailey | Nurse Practitioner | 2330 E Meyer Blvd Ste T411, Kansas City, MO 64132-1162 | 2019-09-25 |
1326694605 | Affirm Management and Consulting, LLC | Nurse Practitioner | 4728 S Campbell Ave Ste 128, Springfield, MO 65810-1715 | 2019-08-13 |
1588122311 | Meskerm Workiye Asfaw | Nurse Practitioner | 589 Vintage Grove Ct, Wildwood, MO 63038-2314 | 2019-03-11 |
1063983088 | Jenny Lynette Brown | Nurse Practitioner | 6912 Candlewick Way, Florissant, MO 63033-5113 | 2018-12-17 |
1992270011 | Andrew Joseph Gucciardo | Nurse Practitioner | 12348 Old Tesson Rd Ste 250, Saint Louis, MO 63128-2261 | 2018-10-04 |
1679065098 | Aaron Dewayne Gitthens | Nurse Practitioner | 898 Sw State Route O, Osborn, MO 64474-9762 | 2018-06-01 |
1548763121 | Jennifer Williams | Nurse Practitioner | 4618 Colima Ct, Saint Louis, MO 63128-2309 | 2018-03-09 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.