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General NPI Number Information
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NPI Number | 1760905756
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Entity Type | Individual
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Provider Name | JENNIFER NICOLE SELBY RN, AGACNP
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Gender | Female
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Dates
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Enumeration Date | 07/20/2017
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 105 MARYS AVE
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City | KINGSTON
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State | NY
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Zip | 12401-5829
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Country | US
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Telephone | 845-338-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 45 READE PL
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City | POUGHKEEPSIE
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State | NY
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Zip | 12601-3947
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Country | US
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Telephone | 845-454-8500
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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 | 14790
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 431159
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License Number State | NY
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