Provider Demographics
NPI:1033382528
Name:MYNHIER, SELENA RENEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:SELENA
Middle Name:RENEE
Last Name:MYNHIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-9185
Mailing Address - Country:US
Mailing Address - Phone:606-207-4381
Mailing Address - Fax:
Practice Address - Street 1:40 JACKSON DR
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-9185
Practice Address - Country:US
Practice Address - Phone:606-207-4381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1100290163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse