Provider Demographics
NPI:1063680411
Name:FELTON, SELINA LYNESE (RDMS RTR)
Entity Type:Individual
Prefix:MS
First Name:SELINA
Middle Name:LYNESE
Last Name:FELTON
Suffix:
Gender:F
Credentials:RDMS RTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 TAMARACK WAY
Mailing Address - Street 2:APT 3A
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4458
Mailing Address - Country:US
Mailing Address - Phone:757-869-2463
Mailing Address - Fax:
Practice Address - Street 1:714 TAMARACK WAY
Practice Address - Street 2:APT 3A
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4458
Practice Address - Country:US
Practice Address - Phone:757-869-2463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic