Healthcare Provider Details

I. General information

NPI: 1467615393
Provider Name (Legal Business Name): ALTHEIA BASS-SELDON DNP, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ALTHEIA WARE

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 FENDLEY TRACE
NEWNAN GA
30263
US

IV. Provider business mailing address

90F GLENDA TRCE STE 344
NEWNAN GA
30265-3858
US

V. Phone/Fax

Practice location:
  • Phone: 678-578-5833
  • Fax:
Mailing address:
  • Phone: 678-578-5833
  • Fax: 678-578-5830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP142278
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: