MEDICARE: REAGAN SELLERS

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	363L00000X	Nurse Practitioner	908334	MS

General Provider Information

NPI Number	:	1477495117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REAGAN SELLERS

Provider Business Mailing Address
First Line	:	PO BOX 223
Second Line	:
City	:	MACON
State	:	MS
Zip	:	39341-0223
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1514 23RD AVE
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39301-4026
Country	:	US
Telephone Number	:	601-531-3969
Fax Number	:

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

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	05/11/2026

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Directions to “ REAGAN SELLERS ” Practice Location

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