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General NPI Number Information
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NPI Number | 1982515995
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Entity Type | Individual
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Provider Name | BLAKESLEY RAE SELBY APRN
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Gender | Female
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Dates
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Enumeration Date | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 197 WILL WALKER RD
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City | COLUMBIA
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State | KY
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Zip | 42728-7436
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Country | US
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Telephone | 270-384-9981
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Fax |
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Provider Business Mailing Address
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Address Line | 837 SELBY BRANCH RD
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City | RUSSELL SPRINGS
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State | KY
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Zip | 42642-6800
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Country | US
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Telephone | 270-250-4794
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4063743
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License Number State | KY
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