Healthcare Provider Details

I. General information

NPI: 1467965228
Provider Name (Legal Business Name): AREKEVA THEODORE-SELMON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 W ESPLANADE AVE
KENNER LA
70065
US

IV. Provider business mailing address

180 W ESPLANADE AVE
KENNER LA
70065-2467
US

V. Phone/Fax

Practice location:
  • Phone: 504-468-8600
  • Fax:
Mailing address:
  • Phone:
  • Fax: 504-464-8159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP09647
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP09647
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: