Individual
ALEXIS SELVESYUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21764 OMEGA CT, GOSHEN, IN 46528-7809
(574) 891-4920
Mailing address
21764 OMEGA CT, GOSHEN, IN 46528-7809
(574) 891-4920
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28264843A
IN
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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