Individual
SELENICA NIVON BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8 JUSTICE LN, ANDERSON, SC 29621-2354
(864) 260-9910
(864) 260-0209
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5083
SC
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/05/2023
Last updated
10/23/2023
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