Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 1729 | MN |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | R160234-2 | MN |
NPI | 1508154691 |
---|---|
Provider Name | Nicole A. Selle |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2011 |
Last Update Date | 06/10/2020 |