Provider Demographics
NPI:1376257154
Name:SELNER, DANA MICHELLE
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MICHELLE
Last Name:SELNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 COLLEGE BLVD UNIT 5246
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1484
Mailing Address - Country:US
Mailing Address - Phone:281-389-7605
Mailing Address - Fax:
Practice Address - Street 1:1916 GRAND BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-1803
Practice Address - Country:US
Practice Address - Phone:913-297-7472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-81316-121363L00000X
MO2022030042363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner