Healthcare Provider Details

I. General information

NPI: 1295043966
Provider Name (Legal Business Name): JANET KIMBERLY SELZ ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2010
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 S TRADE ST
MATTHEWS NC
28105-5772
US

IV. Provider business mailing address

4111 TOM STARNES RD
WAXHAW NC
28173-8227
US

V. Phone/Fax

Practice location:
  • Phone: 704-841-8882
  • Fax:
Mailing address:
  • Phone: 704-451-4359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4346
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5008133
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: