Individual
MRS. SELENA NICOLE DATTOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
3825 S NOLAND RD, INDEPENDENCE, MO 64055-3344
(866) 389-2727
(866) 389-2727
Mailing address
3825 S NOLAND RD, INDEPENDENCE, MO 64055-3344
(866) 389-2727
(866) 389-2727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015014596
MO
Other
Enumeration date
08/25/2015
Last updated
02/24/2019
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