Provider Demographics
NPI:1093107021
Name:SELINKA, JANET A (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:A
Last Name:SELINKA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 CHURCHILL LN
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1808
Mailing Address - Country:US
Mailing Address - Phone:215-335-4416
Mailing Address - Fax:215-338-4426
Practice Address - Street 1:2417 WELSH RD STE 202
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-2210
Practice Address - Country:US
Practice Address - Phone:215-335-4416
Practice Address - Fax:215-338-4426
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN05922L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse