Individual
NICOLE RENEE SELENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5301 MCAULEY DR, YPSILANTI, MI 48197-1051
(734) 712-3000
Mailing address
3060 NEWCASTLE RD, ANN ARBOR, MI 48104-4148
(970) 420-3966
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
51799
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023255
KAISER COMMERCIAL NUMBER
CO
05
—
14520851
—
CO
Enumeration date
05/06/2009
Last updated
12/23/2021
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