Individual
JACQUELINE SELIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
HIGHWAY 191 AND HOSPITAL ROAD, CHINLE, AZ 86503
(928) 674-7166
(928) 674-7705
Mailing address
PO BOX PH, CHINLE, AZ 86503-8000
(928) 674-7166
(928) 674-7705
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP60293807
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP60293807
STATE LICENSE
WA
Enumeration date
09/25/2012
Last updated
09/25/2012
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