Individual
MRS. KATHERINE LYNN SELBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
137 MITCHELLS CHANCE RD, EDGEWATER, MD 21037-2787
(410) 955-5000
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3007745
KY
363LF0000X
Family Nurse Practitioner
Primary
AC006945
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000797018
ANTHEM - NCMA
KY
01
—
143386
SIHO - NCMA
KY
05
—
201130600
—
IN
01
—
50044934
PASSPORT - NCMA
KY
05
—
7100227850
—
KY
Enumeration date
11/15/2012
Last updated
11/20/2024
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