Healthcare Provider Details

I. General information

NPI: 1649274143
Provider Name (Legal Business Name): KARLA SELLERS MS, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2191 DEFENSE HWY STE 201
CROFTON MD
21114-2469
US

IV. Provider business mailing address

9512 NIGHTSONG LN
COLUMBIA MD
21046-2065
US

V. Phone/Fax

Practice location:
  • Phone: 410-451-9091
  • Fax:
Mailing address:
  • Phone: 301-725-6926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR090290
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: