Individual
MRS. GEORJENA RENEE SELVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
BAPTIST HEALTH MEDICAL CENTER-LITTLE ROCK, 9601 INTERSTATE 630, EXIT 7, LITTLE ROCK, AR 72205
(501) 202-1889
Mailing address
1620 KAVANAUGH BLVD, LITTLE ROCK, AR 72205-4116
(501) 346-7856
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
756
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5Y286
MNT PROVIDER
AR
Enumeration date
06/26/2006
Last updated
07/08/2007
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