MEDICARE: DR. VIRGINIA MICHELE SELANIK DNP, FNP

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	363LF0000X	Family Nurse Practitioner	40156	WV
2	363LF0000X	Family Nurse Practitioner	AP139229	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	550691297	OTHER		SELECT NET PLUS
2	550691297	OTHER		TRI CARE
3	001721073	OTHER	WV	BLUE CROSS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	550691297	OTHER		4 MOST

General Provider Information

NPI Number	:	1881664936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIRGINIA MICHELE SELANIK DNP, FNP

Provider Business Mailing Address
First Line	:	6801 S IH 35 STE 1-E
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-4824
Country	:	US
Telephone Number	:	512-978-9960
Fax Number	:	512-776-0470

Provider Business Practice Location Address
First Line	:	6801 S IH 35 STE 1-E
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-4824
Country	:	US
Telephone Number	:	512-978-9960
Fax Number	:	512-776-0470

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

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	05/17/2019

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Directions to “ DR. VIRGINIA MICHELE SELANIK DNP, FNP” Practice Location

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