Provider Demographics
NPI:1679587984
Name:SELVIN, RHONDA C (FNP)
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:C
Last Name:SELVIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 351
Mailing Address - Street 2:
Mailing Address - City:WISCASSET
Mailing Address - State:ME
Mailing Address - Zip Code:04578-4133
Mailing Address - Country:US
Mailing Address - Phone:207-882-6008
Mailing Address - Fax:207-882-7803
Practice Address - Street 1:66 WATER STR
Practice Address - Street 2:
Practice Address - City:WISCASSET
Practice Address - State:ME
Practice Address - Zip Code:04578-4133
Practice Address - Country:US
Practice Address - Phone:207-882-6008
Practice Address - Fax:207-882-7803
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81423363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME277200099Medicaid
MES95783Medicare UPIN
ME277200099Medicaid