Jessica Selvidge

Individual provider Active NPI Licensed Practical Nurse · Springfield, MI

NPI 1992160873 · NPPES record last updated Dec 21, 2015

Key facts

NPI
1992160873
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703106030 (MI)
Practice address
1822 Harmonia Rd
Springfield, MI 49037-7688
Phone
(269) 986-1199
NPI assigned
Dec 21, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4703106030MIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703106030 MI Yes

Addresses

Primary practice location

1822 Harmonia Rd
Springfield, MI 49037-7688

Mailing address

1822 Harmonia Rd
Springfield, MI 49037-7688
Phone (269) 986-1199

Other providers in Springfield, MI

All providers in Springfield, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.