Provider Demographics
NPI:1154334035
Name:SELBY, ANDREA LOUISE (DC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LOUISE
Last Name:SELBY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 GLEN ECHO RD STE 120
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2876
Mailing Address - Country:US
Mailing Address - Phone:615-383-0244
Mailing Address - Fax:615-386-3752
Practice Address - Street 1:2000 GLEN ECHO RD STE 120
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2876
Practice Address - Country:US
Practice Address - Phone:615-383-0244
Practice Address - Fax:615-386-3752
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0029705OtherBLUE CROSS BLUE SHIELD
SD4267611OtherAETNA
TN0029705OtherBLUE CROSS BLUE SHIELD
SD4267611OtherAETNA