Provider Demographics
NPI:1306379896
Name:SELLAND, JOYCE A (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:A
Last Name:SELLAND
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:A
Other - Last Name:GERAETS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:PO BOX 200
Mailing Address - Street 2:1323 BIA ROUTE 4
Mailing Address - City:FT. THOMPSON
Mailing Address - State:SD
Mailing Address - Zip Code:57339
Mailing Address - Country:US
Mailing Address - Phone:605-245-1618
Mailing Address - Fax:605-245-2177
Practice Address - Street 1:1323 BIA ROUTE 4
Practice Address - Street 2:
Practice Address - City:FT. THOMPSON
Practice Address - State:SD
Practice Address - Zip Code:57339
Practice Address - Country:US
Practice Address - Phone:605-245-1618
Practice Address - Fax:605-245-2277
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDSD-LPN P004198164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse