Selena Michelle Korbut

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

1103324 Issued in TX

Practice address

3305 E Fry Blvd
Sierra Vista, AZ 85635-2990

Phone

(520) 515-2930

NPI assigned

Aug 15, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1821820168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 QUENTIN DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782013732",
            "telephone_number": "210-643-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 E FRY BLVD",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352990",
            "telephone_number": "520-515-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORBUT",
        "first_name": "SELENA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1103324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan David Knapp, MD
• Susan Knowles, NP
• Kohif Pharmagenix LLC
• Rachel Elizabeth Kollwitz, LIAC, LCDC
• Hugh Mohamad Kolomar, M.D.
• Debra Ann Kordosky, RN
• Jordanne Blanche Koulong Kuemene, PHARMD
• Daniel Peter Kozar, PHD
• Julie Ann Kreiner, RN
• Lisa Krieg, RN, BSN

• Registered Nurse in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.