NPI Code Details Logo

NPI 1730001579

NPI 1730001579 : SELANA HANEY : GREENVILLE, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1730001579
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    SELANA HANEY
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/25/2026
-----------------------------------------------------
    Last Update Date     |    07/25/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    301 DIVISION ST 
-----------------------------------------------------
    City                 |    GREENVILLE
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    75401-4101
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    719-373-2010
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    15020 COUNTY ROAD 355 
-----------------------------------------------------
    City                 |    TERRELL
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    75161-6247
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    719-373-2010
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LP0808X
-----------------------------------------------------
    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
    License Number       |    1012062
-----------------------------------------------------
    License Number State |    TX
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.