MEDICARE: LYNDA SELK APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	153967	AK
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	275833	AZ

General Provider Information

NPI Number	:	1437318383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNDA SELK APRN

Provider Business Mailing Address
First Line	:	1850 HICKORY DR
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86406-7532
Country	:	US
Telephone Number	:	907-830-6208
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 ACOMA BLVD S STE B102
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5998
Country	:	US
Telephone Number	:	928-397-1587
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	09/17/2025

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