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General NPI Number Information
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NPI Number | 1639906787
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Entity Type | Individual
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Provider Name | DESTINY E SELLERS PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 2001 CLUB MANOR DR
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City | MAUMELLE
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State | AR
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Zip | 72113-7777
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Country | US
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Telephone | 501-734-8085
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Fax | 501-734-8088
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Provider Business Mailing Address
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Address Line | 2001 CLUB MANOR DR
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City | MAUMELLE
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State | AR
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Zip | 72113-7777
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Country | US
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Telephone | 501-734-8085
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Fax | 501-734-8088
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | R099041
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | R099041
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 230665
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License Number State | AR
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