Individual
BARBARA JEAN SELVIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3401 N 67TH AVE, PHOENIX, AZ 85033-4517
(623) 691-4085
(623) 691-5924
Mailing address
3401 N 67TH AVE, PHOENIX, AZ 85033-4517
(623) 691-4085
(623) 691-5924
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN035283
AZ
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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