Healthcare Provider Details

I. General information

NPI: 1952693103
Provider Name (Legal Business Name): KATRINA B SELL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATRINA B SCOTT ARNP

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 CHESTER AVE
JACKSONVILLE FL
32217-2250
US

IV. Provider business mailing address

9838 OLD BAYMEADOWS RD # 388
JACKSONVILLE FL
32256-8101
US

V. Phone/Fax

Practice location:
  • Phone: 904-332-7431
  • Fax: 904-332-7408
Mailing address:
  • Phone: 904-332-7431
  • Fax: 904-332-7408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9172712
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: