Individual
SELENA CLEARMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
7100 U S HIGHWAY 98 STE 140, HATTIESBURG, MS 39402
(601) 261-5710
(601) 268-5058
Mailing address
7100 U S HIGHWAY 98 STE 140, HATTIESBURG, MS 39402-8557
(601) 261-5710
(601) 268-5058
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R852019
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123556
—
MS
01
—
11552881
CAQH ID NUMBER
MS
01
—
7684480
AETNA
MS
01
—
P00718596
RAILROAD MEDICARE
MS
Enumeration date
12/29/2005
Last updated
09/05/2018
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