Healthcare Provider Details

I. General information

NPI: 1962099127
Provider Name (Legal Business Name): SELMA G NIMENE-COLEMAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2020
Last Update Date: 09/05/2023
Certification Date: 12/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THE BELVEDERE 2507 CHESTNUT STREET
CHESTER PA
19013
US

IV. Provider business mailing address

95 EARLINGTON RD
HAVERTOWN PA
19083-5735
US

V. Phone/Fax

Practice location:
  • Phone: 267-300-8708
  • Fax:
Mailing address:
  • Phone: 267-248-6409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP022986
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: