Individual
MRS. AMANDA MARIE SELKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
205 TOWER DR, MONROE, IN 46772-9362
(260) 692-6163
(260) 728-3949
Mailing address
205 TOWER DR, MONROE, IN 46772-9362
(260) 692-6163
(260) 728-3949
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28160341A
IN
363LF0000X
Family Nurse Practitioner
Primary
71003269A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200989710
—
IN
Enumeration date
05/18/2010
Last updated
10/21/2010
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