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General NPI Number Information
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NPI Number | 1679925895
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Entity Type | Individual
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Provider Name | ALEXIS ROSE SELL MSN, RN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/12/2016
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | MONTCLAIR STATE UNIVERSITY HEALTH CENTER 1 NORMAL AVENUE
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City | MONTCLAIR
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State | NJ
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Zip | 07043-1624
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Country | US
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Telephone | 973-655-4361
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Fax |
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Provider Business Mailing Address
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Address Line | MONTCLAIR STATE UNIVERSITY HEALTH CENTER 1 NORMAL AVENUE
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City | MONTCLAIR
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State | NJ
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Zip | 07043-1624
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Country | US
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Telephone | 973-655-4361
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 307715
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ00628400
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License Number State | NJ
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