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NPI Code Detail

MEDICARE: DIANA S SELVEY CNM

MEDICARE:   DIANA S SELVEY  CNM
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
1367A00000XAdvanced Practice Midwife233983TX

General Provider Information

NPI Number : 1902968191
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA S SELVEY CNM
Provider Business Mailing Address
First Line : 1204 N MOUND ST
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75961-4027
Country : US
Telephone Number : 936-568-8425
Fax Number :
Provider Business Practice Location Address
First Line : 1108 SOUTH ST
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75964-5986
Country : US
Telephone Number : 936-560-3097
Fax Number : 936-462-8495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 05/23/2023

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Directions to “ DIANA S SELVEY CNM” Practice Location

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