Healthcare Provider Details

I. General information

NPI: 1912334269
Provider Name (Legal Business Name): JULIA O SELAH A.N.P.-B.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NATIONAL INSTITUTES OF HEALTH 10 CENTER DRIVE, BLDG.10, ROOM B1N264B6
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

797 CENTER ST
HERNDON VA
20170-4611
US

V. Phone/Fax

Practice location:
  • Phone: 301-594-6780
  • Fax: 301-480-1144
Mailing address:
  • Phone: 703-216-0712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRI95045
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAC000895
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number43498
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0024082927
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001082927
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: